| 1. |
- Beerens, Hanneke C., et al.
(författare)
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Quality of Life and Quality of Care for People With Dementia Receiving Long Term Institutional Care or Professional Home Care: The European RightTimePlaceCare Study
- 2014
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Ingår i: Journal of the American Medical Directors Association. - : Elsevier BV. - 1525-8610. ; 15:1, s. 54-61
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To explore how quality of life (QoL) and quality of care (QoC) for people with dementia (PwD) vary across 8 European countries; to explore how QoL and QoC for PwD vary across living arrangements; and to assess the association between QoL and QoC. Design: Cross-sectional survey. Setting: Institutional long term care and home care in 8 European countries (England, Estonia, Finland, France, Germany, the Netherlands, Spain, and Sweden). Participants: PwD receiving formal home care but at risk for admission to an institutional setting, and PwD who were recently admitted. Measurements: QoL was assessed by the PwD and by their best informed proxies using the Quality of Life-Alzheimer's Disease scale (QoL-AD) (range 13-52). QoC was measured using quality of care indicators (eg, the presence of depressive symptoms, the presence of pressure ulcers). Results: A total of 1123 PwD living at home (mean age 82.2, 63%women) and 791 PwD living in institutional care (mean age 84.1, 74% women) participated. QoL of PwD was most often rated highest in Sweden and England and lowest in Estonia and Spain. No differences in QoL were detected among the settings. For the QoC indicators, no consistent patterns were visible in such away that certain countries or settings scored "higher" or "lower." The presence of depressive symptoms was most consistently associated with lower QoL (P <= .001). Conclusion: There is great variation in QoL and QoC scores among European countries and settings. To gain insight into the underlying causes of these differences, more knowledge is needed about the effect of different national health care systems and dementia strategies on QoL and QoC indicators. Depressive symptoms were associated with QoL, and executing longitudinal studies investigating which factors are associated with change in QoL is highly recommended. Copyright (C) 2014 - American Medical Directors Association, Inc.
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| 2. |
- de Mauleon, Adelaide, et al.
(författare)
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Associated Factors With Antipsychotic Use in Long-Term Institutional Care in Eight European Countries: Results From the RightTimePlaceCare Study
- 2014
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Ingår i: Journal of the American Medical Directors Association. - Philadelphia : Elsevier. - 1525-8610 .- 1538-9375. ; 15:11, s. 812-818
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To determine factors associated with the antipsychotic (AP) prescription for people with dementia (PwD) recently admitted to institutional long-term carefacilities (LTCFs) and to ascertain differences in the use of this medication in 8 European countries.Design: An exploratory cross-sectional study.Setting: LTCFs from 8 European countries (Estonia, Finland, France, Germany, The Netherlands, Spain, Sweden, and England).Participants: A total of 791 PwD recently admitted to an LTCF and their caregivers.Measurements: Baseline data from RightTimePlaceCare survey was used. Patients' medical conditions, neuropsychiatric symptoms, physical and cognitive status, and medications were recorded. Multiple logistic regression models were used to assess associations with the AP use. Results: A group of 296 patients (37.4%) of 791 patients recently admitted received AP medication. The prevalence of the use of 1 or more APs varied between study countries, ranging from 12% in Sweden to 54% inSpain. Factors independently associated with the AP use were living in Sweden [odds ratio (OR) 0.12, 95% confidence interval (CI) 0.05-0.30], Finland (OR 0.26, 95% CI 0.14-0.48), Germany (OR 2.75, 95% CI 1.55-4.86) and Estonia (OR 6.79, 95% CI 3.84-12.0). The odds of AP use decreased with the presence of a dementia specific unit inthe LTCF (OR 0.60, 95% CI 0.39-0.92), but was higher among residents with a hyperactivity behavior (OR 2.12, 95% CI 1.41-3.18).Conclusion: The current study shows that more than one-third of the residents recently admitted received APs and that prescription frequency across countries varied significantly. This study raises the possibility that the presence of a dementia-specific unit might play a role in the AP use. Further studies should investigate this association and seek better understanding of what will achieve optimal quality of AP use among newly admitted residents in LTCF. © 2014 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
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| 3. |
- Hallberg, Ingalill R, et al.
(författare)
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The dementia care system in the eight RTPC European countries
- 2013
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Ingår i: The Journal of Nutrition, Health & Aging. - Heidelberg : Springer. - 1279-7707 .- 1760-4788. ; 17:Suppl. 1, s. S212-S212
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Exploring the care and service activities offered throughout the trajectory of dementia is an opportunity for countries to learn from each other. As part of the RightTimePlaceCare project’s general objective to develop best practice strategies this presentation describes development, content and application of a template to explore the dementia health, social care and welfare systems from early sign, diagnosis, intermediate and moderate stage and to the late stage of the disease. It also describes some of the findings with regard to the chain of care and service for people with dementia.Method: A step-wise consensus procedure was applied to identify, define and develop a template covering care and service throughout the disease trajectory. In addition the professionals involved were identified and defined as for their educational level.Results: In total 50 care and service activities compiled in seven groups were identified: 1) Screening, diagnostic procedure, treatment of dementia and complications; 2) Outpatient care facilities; 3) Care at home; 4) Institutional care; 5) Palliative care; 6) Informal caregiving and support; 7) Civic activities. The largest differences in terms of availability were found for care activities specifically for people with dementia. Non-pharmacological treatment was not commonly utilized in whilst pharmacological treatment for BPSD was common. Also education and social support to family caregivers was sparsely utilized.Conclusion: The care and service offered to people with dementia and family caregivers covers a wide range of activities. Facilities specifically for dementia varies among countries.There are more similarities among countries than differences.
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| 4. |
- Lethin, Connie, et al.
(författare)
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Formal support for informal caregivers to persons with dementia through the trajectory of the disease in eight European countries
- 2015
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Ingår i: Abstract Booklet. ; , s. 237-237
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Konferensbidrag (refereegranskat)abstract
- Objectives: In European countries knowledge about availability and utilisation of support for informal caregivers caring for older person with dementia (PwD) is lacking. To be able to evaluate and develop the dementia support system forinformal caregivers to a PwD, a survey of European support systems and professional providers could serve as a knowledge base and enable European countries to learn from each other.The aim was to explore support for informal caregivers to PwD in terms of availability and utilisation, and to explore professional care providers and their educational levels involved in the support for informal caregivers to PwD through the trajectory of disease across eight European countries.Methods: A mapping system aiming to explore care and service for PwD and informal caregivers in eight European countries was used (Hallberg et al., 2013) to gather information about availability, utilisation and providers of support to informal caregivers caring for PwD.Results: Counselling, caregiver support and education where the support activities that had high availability in the diagnose stage to the intermediate stage with a decrease in late to end of life stage. Utilization was low with a small increase in the intermediate stage. Day care and respite care at home had high availability in the diagnose stage to the intermediate stage with a decrease in the late to end of life stage, utilized by no one or few through all stages. Professionals specialised in dementia (Bachelor to Master degree) provided counselling, education while caregiver support for informal caregivers and day care, respite care and respite care at home as relief for informal caregivers was provided by professionals from upper secondary school to a master degree.Conclusion: Availability and utilisation of support for informal caregivers appears to be related to each countries care and support systems. Countries with National guidelines for PwD and informal caregivers seemed to be more aware about the importance of professionals specialised in dementia in the support.
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| 5. |
- Lethin, Connie, et al.
(författare)
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Prevalence of dementia diagnosis not otherwise specified in eight European countries A cross-sectional cohort study
- 2019
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Ingår i: BMC Geriatrics. - : Springer Science and Business Media LLC. - 1471-2318. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundDementia is a syndrome, with a wide range of symptoms. It is important to have a timely diagnosis during the disease course to reduce the risk of medication errors, enable future care planning for the patient and their relatives thereby optimizing quality of life (QoL). For this reason, it is important to avoid a diagnosis of dementia not otherwise specified (DNOS) and instead obtain a diagnosis that reflects the underlying pathology. The aim of this study was to investigate the prevalence and associated factors of DNOS in persons with dementia living at home or in a nursing home.MethodsThis is a cross-sectional cohort study performed in eight European countries. Persons with dementia aged ≥65 years living at home (n = 1223) or in a nursing home (n = 790) were included. Data were collected through personal interviews with questionnaires based on standardised instruments. Specific factors investigated were sociodemographic factors, cognitive function, and mental health, physical health, QoL, resource utilization and medication. Bivariate and backward stepwise multivariate regression analyses were performed.ResultsThe prevalence of DNOS in the eight participating European countries was 16% (range 1–30%) in persons living at home and 21% (range 1–43%) in persons living in a nursing home. These people are more often older compared to those with a specific dementia diagnosis. In both persons living at home and persons living in a nursing home, DNOS was associated with more severe neuropsychiatric symptoms and less use of anti-dementia medication. In addition, persons with DNOS living at home had more symptoms of depression and less use of antidepressant medication.ConclusionsThe prevalence of DNOS diagnosis is common and seems to vary between European countries. People with DNOS are more often older with more severe neuropsychiatric symptoms and receive fewer anti-dementia medication, anxiolytics and antidepressants. This would support the suggestion that a proper and specific diagnosis of dementia could help the management of their disease.
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