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Zeitschrift für Gerontologie und Geriatrie

, Volume 51, Issue 5, pp 530–536 | Cite as

Access to community care for people with dementia and their informal carers

Case vignettes for a European comparison of structures and common pathways to formal care
  • A. Bieber
  • A. Stephan
  • H. Verbeek
  • F. Verhey
  • L. Kerpershoek
  • C. Wolfs
  • M. de Vugt
  • R. T. Woods
  • J. Røsvik
  • G. Selbaek
  • B. M. Sjölund
  • A. Wimo
  • L. Hopper
  • K. Irving
  • M. J. Marques
  • M. Gonçalves-Pereira
  • E. Portolani
  • O. Zanetti
  • G. MeyerEmail author
Original Contribution

Abstract

Background

People with dementia and their informal carers often do not receive appropriate professional support or it is not received at the right time.

Objectives

Description and comparison of common pathways to formal community dementia care in eight European countries as a part of the transnational Actifcare project.

Materials and methods

The German team was responsible for creating an individual case scenario as a starting point. The research teams in Ireland, Italy, the Netherlands, Norway, Portugal, Sweden, and the United Kingdom were then asked to describe a common pathway to formal dementia care by writing their own vignette using the provided individual case scenario.

Results

A transnational qualitative content analysis was used to identify the following categories as being the most important: involved professionals, dementia-specific and team-based approaches, proactive roles, and financial aspects. General practitioners (GPs) are described as being the most important profession supporting the access to formal care in all the involved countries. In some countries other professionals take over responsibility for the access procedure. Dementia-specific approaches are rarely part of standard care; team-based approaches have differing significances in each of the countries. Informal carers are mainly proactive in seeking formal care. The Nordic countries demonstrate how financial support enhances access to the professional system.

Conclusion

Enhanced cooperation between GPs and other professions might optimize access to formal dementia care. Team-based approaches focusing on dementia care should be developed further. Informal carers should be supported and relieved in their role. Financial barriers remain which should be further investigated and reduced.

Keywords

Dementia Health services accessibility Care Comparative study Europe 

Zugang zu professioneller Unterstützung für Menschen mit Demenz und ihre Angehörigen

Fallvignetten für den europäischen Vergleich von Strukturen und Zugangswegen zu professioneller Pflege

Zusammenfassung

Hintergrund

Menschen mit Demenz und ihre Angehörigen erhalten häufig nicht oder nicht rechtzeitig angemessene professionelle Unterstützung.

Ziel der Arbeit

Beschrieben und verglichen werden Zugangswege zu professioneller ambulanter Unterstützung bei Demenz in acht europäischen Ländern als Teil des transnationalen Actifcare-Projekts.

Material und Methode

Das für das Arbeitspaket verantwortliche Team aus Deutschland erstellte eine Fallvignette als Prototyp; die wissenschaftlichen Teams in Irland, Italien, den Niederlanden, Norwegen, Portugal, Schweden und Großbritannien erhielten den Auftrag, darauf aufbauend den typischen Zugangsweg zu professioneller Unterstützung bei Demenz in einer individuellen Vignette fortzuschreiben.

Ergebnisse

Mit einer länderübergreifenden qualitativen Inhaltsanalyse wurden als wesentliche Kategorien identifiziert: involvierte Professionen, demenzspezifische und teambasierte Ansätze, proaktive Rollen und finanzielle Aspekte. Als die wichtigste Profession im Zugang zu professioneller Unterstützung wird in allen Ländern der Hausarzt beschrieben. In einigen Ländern übernehmen andere Professionen Verantwortung im Zugangsprozess. Demenzspezifische Strukturen sind kaum Bestandteil der Regelversorgung; teambasierte Ansätze sind in den meisten Ländern unterschiedlich bedeutsam etabliert. Angehörige kümmern sich oft in Eigeninitiative darum, professionelle Hilfen einzubeziehen. Die nordischen Länder zeigen, wie sich durch finanzielle Unterstützung der Zugang zum professionellen System fördern lässt.

Schlussfolgerung

Eine intensivierte Zusammenarbeit zwischen Hausärzten und anderen Professionen könnte den Zugang optimieren. Teambasierte Ansätze sind demenzspezifisch weiterzuentwickeln. Angehörige sind in ihrer Rolle zu unterstützen und zu entlasten. Finanzielle Zugangshürden sind genauer zu identifizieren und zu reduzieren.

Schlüsselwörter

Demenz Zugang zu Gesundheitsangeboten Professionelle Pflege Vergleichsstudie Europa 

Notes

Compliance with ethical guidelines

Conflict of interest

A. Bieber, A. Stephan, H. Verbeek, F. Verhey, L. Kerpershoek, C. Wolfs, M. de Vugt, R.T. Woods, J. Røsvik, G. Selbaek, B.M. Sjölund, A. Wimo, L. Hopper, K. Irving, M. Marques, M. Gonçalves-Pereira, E. Portolani, O. Zanetti and G. Meyer declare that they have no competing interests.

This article does not contain any studies with human participants or animals performed by any of the authors.

Supplementary material

391_2017_1266_MOESM2_ESM.docx (13 kb)
Supplementary Material 1 presents information on the described structures and components related to access to formal care and an excerpt of the described structures. Supplementary Material 2 comprises the introduction to the case scenario as the starting point for national common pathways to formal dementia care.

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Copyright information

© Springer Medizin Verlag GmbH 2017

Authors and Affiliations

  • A. Bieber
    • 1
  • A. Stephan
    • 1
  • H. Verbeek
    • 2
  • F. Verhey
    • 2
  • L. Kerpershoek
    • 2
  • C. Wolfs
    • 2
  • M. de Vugt
    • 2
  • R. T. Woods
    • 3
  • J. Røsvik
    • 4
  • G. Selbaek
    • 4
  • B. M. Sjölund
    • 5
    • 9
  • A. Wimo
    • 5
  • L. Hopper
    • 6
  • K. Irving
    • 6
  • M. J. Marques
    • 7
  • M. Gonçalves-Pereira
    • 7
  • E. Portolani
    • 8
  • O. Zanetti
    • 8
  • G. Meyer
    • 1
    Email author
  1. 1.Medical Faculty, Institute for Health and Nursing ScienceMartin Luther University Halle-WittenbergHalle (Saale)Germany
  2. 2.School for Mental Health and Neuroscience, Alzheimer Center Limburg, Department of Psychiatry and NeuropsychologyMaastricht University Medical CenterMaastrichtThe Netherlands
  3. 3.Dementia Services Development Centre WalesBangor UniversityBangorUK
  4. 4.Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, and Department of Geriatric MedicineOslo University HospitalOsloNorway
  5. 5.Department of Neurobiology, Care sciences and SocietyKarolinska InstitutStockholmSweden
  6. 6.School of Nursing and Human SciencesDublin City UniversityDublinIreland
  7. 7.CEDOC, Chronic Diseases Research Centre, Nova Medical School/Faculdade de Ciências MédicasUniversidade Nova de LisboaLisbonPortugal
  8. 8.Alzheimer’s Research Unit-Memory ClinicBresciaItaly
  9. 9.Department of Health and Caring ServicesUniversity of GävleGävleSweden

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