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Best practice and needs for improvement in the chain of care for persons with dementia in Sweden: a qualitative study based on focus group interviews

Author:
  • Christina Bökberg
  • Gerd Ahlström
  • Staffan Karlsson
  • Ingalill Rahm Hallberg
  • Ann-Christin Janlov
Publishing year: 2014
Language: English
Publication/Series: BMC Health Services Research
Volume: 14
Document type: Journal article
Publisher: BioMed Central

Abstract english

Background: Persons with dementia receive health care and social services from a wide range of professional care providers during the disease trajectory, presenting risks of miscommunication, duplication and/or missed nursing interventions. Accordingly, the aim of this study was to investigate professional care providers' views on conditions for best practice in terms of collaboration and improvement needs in the chain of care from early to end-of-life stage for persons with dementia in Sweden. Methods: The study had a qualitative design based on three focus group interviews. A strategic sample of 23 professional care providers was included. Data were subjected to content analysis based on the three stages of dementia (early, moderate, end-of-life). Results: The results were divided into five categories: Diagnosis is a prerequisite for specialized dementia care, Creating routines in the chain of care, Competent staff a prerequisite for high-quality care, Day care facilitates transition in the chain of care and Next-of-kin participation is a prerequisite for continuity in the chain of care. It was clear that, according to the participants, best practice in dementia care in Sweden is not achieved in every respect. It appeared that transitions of care between different organizations are critical events which need to be improved. The further the disease progresses, the less collaboration there seems to be among professional care providers, which is when the next of kin are usually called upon to maintain continuity in the chain of care. Conclusions: The results indicate that, according to the care providers, best practice in terms of collaboration is achieved to a higher degree during the early stage of dementia compared with the moderate and end-of-life stages. Lack of best practice strategies during these stages makes it difficult to meet the needs of persons with dementia and reduce the burden for next of kin. These are experiences to be taken into account to improve the quality of dementia care. Implementation research is needed to develop strategies for best practice on the basis of national knowledge-based guidelines and to apply these strategies in the moderate and end-of-life stages.

Keywords

  • Health Care Service and Management, Health Policy and Services and Health Economy
  • Dementia care
  • Best practice
  • Transitions
  • Health care
  • Chain of care
  • Home care
  • Nursing home
  • Professional care providers
  • Nursing

Other

Published
  • Older people's health and Person-Centred care
  • ISSN: 1472-6963
Ingalill Rahm Hallberg
E-mail: ingalill [dot] rahm_hallberg [at] med [dot] lu [dot] se

Professor emerita

Health-promoting Complex Interventions

HSC

65