| 1. |
- Bökberg, Christina, et al.
(författare)
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Professional care providers and stakeholders’ views of best practice in the care for persons with dementia in Sweden
- 2013
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Ingår i: The Journal of Nutrition, Health & Aging. - Heidelberg : Springer. - 1279-7707 .- 1760-4788. ; 17:Suppl. 1, s. S369-S370
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Dementia implies progressive loss of mental and physical functions during the trajectory of the disease (Porter & Kaplan, 2012). Persons with dementia need involvement of various and several care providers throughout the stages of dementia, and more knowledge is needed about best practice strategies in this complexity of care (Gurner, 2001). The aim of the study was to explore professional care providers and stakeholders’ views of best practice in concepts of information, collaboration and communication in the care for persons with dementia in Sweden.Method: The study had a qualitative approach based on three focus group interviews with a variation among participants regarding professions and workplaces to represent different types of care for persons with dementia from diagnosis to end of life care. The transcribed verbatim was analyzed with qualitative content analysis.Preliminary results: In early stages primary health care specialized in dementia had close collaboration, training and mentoring, with memory clinic and home care. In the later stages the person with dementia had less frequent contacts with primary health care. Day care played an important role in information delivery of the disease, in collaboration with home and institutional care. In the latest stage the family had an important role as a proxy for the person with dementia about desires in the care.Conclusion: A well-functioning network in professional care seems to have an impact on persons with dementia to remain at home despite loss of mental and physical functions.On the behalf of RightTimePlaceCare consortium. http://www.righttimeplacecare.eu.
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| 2. |
- Bökberg, Christina, et al.
(författare)
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Professional care providers and stakeholders’ views of best practice in the chain of care for persons with dementia in Sweden
- 2013
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Ingår i: Nordic Advances in Health Care Sciences Research. ; , s. 98-98
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Konferensbidrag (refereegranskat)abstract
- Background: To meet the increasing needs for persons with dementia and their relatives a well-functioning health care system in which resources are used optimally is needed. For this to be achieved requires strategy and planning of synergies between the different cares providers. This study will explore professional caregivers’ and stakeholders’ views of best practice in terms of information, collaboration and communication in dementia care.Aim: The aim of the study was to explore professional care providers’ and stakeholders' views of best practice in concepts of information, collaboration and communication throughout the trajectory of care from diagnosis to end of life care for persons with dementia in Sweden.Method: The study had a qualitative approach based on three focus group interviews with a variation among participants regarding professions and workplaces to represent different types of care for persons with dementia from diagnosis to end of life care. The transcribed verbatim was analyzed with qualitative content analysis.Preliminary results: In early stages primary health care specialized in dementia had close collaboration, training and mentoring, with memory clinic and home care. In the later stages the person with dementia had less frequent contacts with primary health care. Day care played an important role in information delivery of the disease, in collaboration with home and institutional care. In the latest stage the family had an important role as a proxy for the person with dementia about desires in the care.Conclusion: A well-functioning network in professional care seems to have an impact on persons with dementia to remain at home despite loss of mental and physical functions.
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| 3. |
- 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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| 4. |
- Giebel, Clarissa, et al.
(författare)
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Deterioration of basic activities of daily living and their impact on quality of life across different cognitive stages of dementia: a European study
- 2014
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Ingår i: International psychogeriatrics. - Cambridge : Cambridge University Press. - 1041-6102 .- 1741-203X. ; 26:8, s. 1283-1293
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Tidskriftsartikel (refereegranskat)abstract
- Background: Performing basic activities of daily living (ADLs) is one of the major difficulties encountered in dementia, which can have considerable negative impacts on the quality of life (QoL) of people with dementia (PwD). However, the extent to which basic ADL performance deteriorates across mild, moderate, and severe dementia is little examined and its impact, together with depression and neuropsychiatric behavior, upon QoL, is of considerable relevance across European countries.Methods: Data were drawn from people living in the community who were participants in a large-scale European study on transition from community living to care homes of PwD. PwD completed measures on cognitive functioning and QoL, and informal carers reported upon QoL, depressive symptomatology, psychopathology, and functional ability of the PwD.Results: ADL performance deteriorated differently for each activity. In particular, toileting, transfer, and feeding remained relatively intact throughout, whereas performance on bathing and dressing deteriorated to a greater extent from mild to severe dementia. It appears that continence was not affected by the stage of dementia with similar levels of impairment. Basic ADL performance impacted to different degrees on QoL across dementia stages and countries.Conclusions: Interventions aimed at maintaining independence or QoL need to target different ADLs across different dementia stages and perhaps also tailor interventions to the context of different countries. Findings contribute to the development of non-pharmaceutical interventions and governmental pledges to promote independence in dementia. © International Psychogeriatric Association 2014
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| 5. |
- Hallberg, Ingalill R, et al.
(författare)
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Structure of long-term home and institutional care available to people with dementia in eight European countries
- 2011
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Ingår i: International psychogeriatrics. - Cambridge : Cambridge University Press. - 1041-6102 .- 1741-203X. ; 23:Suppl. 1, s. S31-S31
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Tidskriftsartikel (refereegranskat)abstract
- The RTPC project also concerns the structure of long-term home and institutional care throughout the trajectory of dementia. To describe and analyse the European health, social care and welfare systems, advocacy and informal caregiver support systems for patients/consumers with dementia a template has been developed for the use of homogenous terminology, covering possible care and service interventions from diagnosis to end of life. The structure of the national health care and social service system was described as related to elderly in general and to people with dementia specifically. The system differs between the eight countries in particular in terms of the demands on informal caregivers, financially, the distribution and the emphasis on home care versus nursing home care. Resembling findings throughout the 8 countries were that few had a diagnosis at early disease stage, support to family caregivers still can be improved and palliative care concepts are sparsely applied.
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| 6. |
- Hallberg, Ingalill R, et al.
(författare)
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Structure of long term home and institutional care systems in Europe
- 2011
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this part of the RightTimePlaceCare study (WP2) was to describe and analyse the European health, social care and welfare systems, advocacy and informal caregiver support systems for patients with dementia. The description and analyses covers the continuum of care from diagnosis, informal care, contributions from civic society, public home care and the intermediate forms of care, to the long-term institutionalised care, and end of life care. In a first step, the terminology was developed and meanings of different terms used in relation to dementia care were collected, analysed, defined and categorised. Thereafter the terminology was used to develop a template organised on the Y-axis as being the course of the dementia disease as described by the OECD in 2004, and on the X-axis as being the type of care provided, organised in accordance with the process of the disease from dementia screening to end of life care. In addition each country was asked to provide an overall description of the care system they offered with regard to the national directives and financing of their dementia care system. The primary source of information was written reports from different sources. Official documents, epidemiological studies and descriptions of the care system, in particular dementia care system offered in their country. In addition interviews with responsible managers, providers or the equivalent in relevant care and service organisations, with persons in consumer/user organisations, with staff, professional employees and purchasers in a municipality or another representative for a civic administrative area were recommended.
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| 7. |
- 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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| 8. |
- Jakobsson, Ulf, et al.
(författare)
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Predicting Mortality With the ADL-Staircase in Frail Elderly
- 2011
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Ingår i: Physical & Occupational Therapy in Geriatrics. - Philadelphia : Taylor & Francis. - 0270-3181 .- 1541-3152. ; 29:2, s. 136-147
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To investigate the ability of the ADL-staircase to predict mortality among older people receiving long-term formal health care and service.Method: This study comprises 626 respondents. Data were collected for 2 cohorts.Results: Crude mortality rate ranged between 9% and 23%. Higher scores on the ADL-staircase significantly increased the risk of mortality (RR = 1.253). For the total sample, Youden's index suggested a cutoff value of 6 for mortality on the ADL-staircase. A cutoff value of 4 was suggested for those living at home and 7 for those in special accommodation. Regression analysis, using these cutoff values, showed a significant association with mortality.Conclusion: Knowledge of how to use the ADL-staircase as a mortality predictor is limited. This study not only found a cutoff point for the total sample but also when grouped by type of housing. The findings may be useful when allocating care and service and when providing preventive interventions and palliative care. © 2011 Informa Healthcare USA, Inc.
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| 9. |
- Johansson, Annika, et al.
(författare)
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Distriktssköterskors erfarenhet av informationen kring pandemin A(H1N1), 2009 = District nurses experiences of the information concerning the pandemic a(HINI), 2009
- 2012
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Ingår i: Vård i Norden. - London : Sage Publications. - 0107-4083 .- 1890-4238. ; 32:3, s. 4-8
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To explore district nurses' experiences of information received from the employer and communicated to patients in the context of the pandemic A(H1N1).Background: Dissemination of oral and written information in pandemics is essential to limit the spread of infection and public concern. Information is channeled via various authorities and health care centers, where district nurses often provide information directly to patients.Method: Transcribed semi structured interviews with 21 district nurses in Region Skåne were analyzed using qualitative content analysis.Results: The district nurses experienced shortfalls in the information communicated from the employer and that the relevant information was often preceded by public media. This made it problematic to provide information concerning pandemic A(H1N1) in a professional manner, as well as to mediate safety and credibility. During the pandemic the district nurses simultaneously sought information from websites, popular science magazines and other public media. The nurses did however express an understanding of the difficulty in this unique situation and have a positive outlook on the use of the intranet for dissemination of information.Conclusion: It is important that district nurses receive prompt and precise information from their employer in a pandemic to facilitate the patients' information needs in credible manner.
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| 10. |
- Karlsson, Staffan, 1959-, et al.
(författare)
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Best practice and needs of improvement in the chain of care for persons with dementia in Sweden
- 2014
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Konferensbidrag (refereegranskat)abstract
- INTRODUCTION: The fragmentation of responsibilities in the chain of care may result in information lost, duplications and discontinuity. This may in turn lead to consequences for the person with dementia dealing with unmet care needs.AIM: The aim of the study was to explore professional care providers’ and stakeholders' views of best practice and needs of improvement of information, collaboration and communication in the chain of care for persons with dementia in Sweden.METHOD: The study was carried out with an explorative qualitative design based on three focus group interviews. The text was analysed with qualitative content analysis.RESULTS: The participants’ views of best practices and needs of improvement resulted in six themes following the trajectory of dementia. “Dementia diagnosis significant for receiving care”, “Day care for person with dementia supportive to home care”, “Collaboration between staff important for information delivery”, “Skilled staff for person-centred care”, “The life story of the person with dementia important source of information”, and “Relatives participation for continuity in the chain of care”. CONCLUSION: A well-functioning network between different professional care providers seems to have an impact on best practice in the chain of care for persons with dementia so they could remain at home despite loss of mental and physical functions.
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