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Bökberg, C., Ahlström, G. & Karlsson, S. (2018). Utilisation of formal and informal care and services at home among persons with dementia: a cross-sectional study. Scandinavian Journal of Caring Sciences, 32(2), 843-851
Open this publication in new window or tab >>Utilisation of formal and informal care and services at home among persons with dementia: a cross-sectional study
2018 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, no 2, p. 843-851Article in journal (Refereed) Published
Abstract [en]

Background

The progression of dementia disease implies increasing needs for both informal and formal care and services but also risk of institutionalisation. To better adjust care and services in the phase preceding institutionalisation it is important to find out whether utilisation of formal and informal care and services is determined by increased needs and by who meets the needs.Aim

The aim was to compare persons with dementia (65+) with different levels of cognitive impairment, regarding utilisation of formal and informal care and service at home.Methods

The participants consisted of 177 persons with dementia ≥65 years old and at risk of nursing home admission, divided into groups according to their cognitive function. Structured interviews were conducted based on questionnaires about type and amount of formal and informal care utilised, as well as questions regarding cognitive impairment, dependency in activities of daily living (ADLs) and neuropsychiatric symptoms. To analyse the data, descriptive and comparative statistics were used.Results

The findings revealed that the group with severe dementia used significantly more help with ADLs and supervision in terms of time (number of hours and days) provided by the informal caregiver, compared with the group with moderate dementia. Utilisation of formal care and services was highest in the group with the most severe cognitive impairments (Standardized Mini-Mental State Examination score of <9). The group with severe dementia were more dependent in ADLs and had more neuropsychiatric symptoms (hallucinations and motor disturbances). They were younger and more often cohabitated with the informal caregiver, compared with the group with moderate dementia.Conclusion

This study shows that in the phase preceding institutionalisation the ADL and supervision needs due to progression of dementia appear to tend to be met first and foremost by the informal caregivers. © 2017 Nordic College of Caring Science.

Place, publisher, year, edition, pages
Chichester: Wiley-Blackwell Publishing Inc., 2018
Keywords
care and services at home, dementia
National Category
Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:hh:diva-34832 (URN)10.1111/scs.12515 (DOI)28869661 (PubMedID)
Projects
RightTimePlaceCare
Funder
EU, FP7, Seventh Framework Programme, 242153Swedish Research Council
Note

The study was a part of the RightTimePlaceCare project supported by a grant from the European Commission within the 7th Framework Programme (project 242153). We would like to acknowledge the support from the Gyllenstierna Krapperup's Foundation. We would also like to acknowledge the support of the Department of Health Sciences, Lund University, Lund, Sweden. This study was accomplished while Christina Bökberg was affiliated with the Swedish National Graduate School for Competitive Science on Ageing and Health (SWEAH), which is funded by the Swedish Research Council.

Available from: 2017-08-30 Created: 2017-08-30 Last updated: 2018-07-03Bibliographically approved
Bökberg, C., Ahlström, G. & Karlsson, S. (2017). Significance of quality of care for quality of life in persons with dementia at risk of nursing home admission: a cross-sectional study. BMC Nursing, 16(1), Article ID 39.
Open this publication in new window or tab >>Significance of quality of care for quality of life in persons with dementia at risk of nursing home admission: a cross-sectional study
2017 (English)In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 16, no 1, article id 39Article in journal (Refereed) Published
Abstract [en]

Background

Quality of life in persons with dementia is, in large part, dependent on the quality of care they receive. Investigating both subjective and objective aspects of quality of care may reveal areas for improvement regarding their care, which information may ultimately enable persons with dementia to remain living in their own homes while maintaining quality of life. The aim of this study was to 1) describe self-reported quality of life in persons with dementia at risk of nursing home admission. 2) describe subjective and objective aspects of quality of care, 3) investigate the significance of quality of care for quality of life.

Methods

A cross-sectional interview study design was used, based on questionnaires about quality of life (QoL-AD) and different aspects of quality of care (CLINT and quality indicators). The sample consisted of 177 persons with dementia living in urban and rural areas in Skåne County, Sweden. Descriptive and comparative statistics (Mann-Whitney U-test) were used to analyse the data.

Results

Based upon Lawton’s conceptual framework for QoL in older people, persons with pain showed significantly lower quality of life in the dimensions behavioural competence (p = 0.026) and psychological wellbeing (p = 0.006) compared with those without pain. Satisfaction with care seemed to have a positive effect on quality of life. The overall quality of life was perceived high even though one-third of the persons with dementia had daily pain and had had a weight loss of ≥4% during the preceding year. Furthermore, 23% of the persons with dementia had fallen during the last month and 40% of them had sustained an injury when falling.

Conclusion

This study indicates need for improvements in home care and services for persons with dementia at risk for nursing home admission. Registered nurses are responsible for nursing interventions related to pain, patient safety, skin care, prevention of accidents, and malnutrition. Therefore, it is of great importance for nurses to have knowledge about areas that can be improved to be able to tailor interventions and thereby improve quality of care outcomes such as quality of life in persons with dementia living at home. © 2017 The Author(s).

Place, publisher, year, edition, pages
London: BioMed Central, 2017
Keywords
Quality of life, Quality of care, Persons with dementia, Home care
National Category
Health Sciences
Identifiers
urn:nbn:se:hh:diva-34831 (URN)10.1186/s12912-017-0230-6 (DOI)000405812500002 ()28725160 (PubMedID)2-s2.0-85023647327 (Scopus ID)
Projects
RightTimePlaceCare
Funder
EU, FP7, Seventh Framework Programme, 242153Swedish Research Council
Available from: 2017-08-30 Created: 2017-08-30 Last updated: 2018-03-23Bibliographically approved
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-0821-1959

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