1
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Røsvik J, Michelet M, Engedal K, Bieber A, Broda A, Gonçalves-Pereira M, Hopper L, Irving K, Jelley H, Kerpershoek L, Meyer G, Marques MJ, Portolani E, Sjölund BM, Sköldunger A, Stephan A, Verhey F, de Vugt M, Woods B, Wolfs C, Zanetti O, Selbaek G. Interventions to enhance access to and utilization of formal community care services for home dwelling persons with dementia and their informal carers. A scoping review. Aging Ment Health 2020; 24:200-211. [PMID: 30663890 DOI: 10.1080/13607863.2018.1523876] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Objectives: Home dwelling people with dementia and their informal carers often do not receive the formal care services they need. This study examined and mapped the research regarding interventions to improve access and use of formal community care services.Method: This is a scoping review with searches in PubMed, CINAHL, PsychINFO, Medline, Cochrane Database of Systematic Reviews, Social Science Citation index and searches of grey literature in international and national databases. Studies were categorized according to the measure used to enhance access or use.Results: From international databases, 2833 studies were retrieved, 11 were included. Five studies were included from other sources. In total, 16 studies published between 1989 and 2018 were examined; seven randomized controlled trials, six pretest-posttest studies and three non-randomized controlled studies. Sample sizes varied from 29 to 2682 participants, follow-up from four weeks to four years. Five types of interventions were identified: Case management, monetary support, referral enhancing, awareness & information focused and inpatient focused. Only two studies had access or use of community services as the primary outcome. Fourteen studies, representing all five types of interventions, had positive effects on one or more relevant outcomes. Two interventions had no effect on relevant outcomes.Conclusion: The included studies varied widely regarding design, type of intervention and outcomes. Based on this, the evidence base for interventions to enhance access to and use of formal community services is judged to be limited. The most studied type of intervention was case management. More research is recommended in this field.
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Affiliation(s)
- Janne Røsvik
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Norway
| | - Mona Michelet
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Norway.,Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Knut Engedal
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Norway
| | - Anja Bieber
- Martin Luther University Halle-Wittenberg, Medical Faculty, Institute of Health and Nursing Sciences, Halle (Saale), Germany
| | - Anja Broda
- Martin Luther University Halle-Wittenberg, Medical Faculty, Institute of Health and Nursing Sciences, Halle (Saale), Germany
| | - Manuel Gonçalves-Pereira
- CEDOC, Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Louise Hopper
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - Kate Irving
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - Hannah Jelley
- Dementia Services Development Centre, Bangor University, Bangor, UK
| | - Liselot Kerpershoek
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Gabriele Meyer
- Martin Luther University Halle-Wittenberg, Medical Faculty, Institute of Health and Nursing Sciences, Halle (Saale), Germany
| | - Maria J Marques
- CEDOC, Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Elisa Portolani
- Alzheimer's Research Unit - Memory Clinic - IRCCS Centro San Giovanni di Dio - Fatebebenefratelli, Brescia, Italy
| | - Britt-Marie Sjölund
- Department of Neurobiology, Care sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Anders Sköldunger
- Department of Neurobiology, Care sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Astrid Stephan
- Martin Luther University Halle-Wittenberg, Medical Faculty, Institute of Health and Nursing Sciences, Halle (Saale), Germany
| | - Frans Verhey
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Marjolein de Vugt
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Bob Woods
- Dementia Services Development Centre, Bangor University, Bangor, UK
| | - Claire Wolfs
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Orazio Zanetti
- Alzheimer's Research Unit - Memory Clinic - IRCCS Centro San Giovanni di Dio - Fatebebenefratelli, Brescia, Italy
| | - Geir Selbaek
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway.,Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway
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2
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Kerpershoek L, Woods B, Wolfs C, Verhey F, Jelley H, Bieber A, Stephan A, Michelet M, Selbaek G, Handels R, Wimo A, Hopper L, Irving K, Marques MJ, Gonçalves-Pereira M, Portolani E, Zanetti O, de Vugt M. Do caregiver profiles predict the use of dementia care services? Findings from the Actifcare study. Aging Ment Health 2020; 24:272-279. [PMID: 30518244 DOI: 10.1080/13607863.2018.1544215] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives: Previously developed dementia caregiver profiles defined by caregiver age and burden, have been associated with caregiver quality of life, depression and perseverance time. The current aim was to investigate whether these caregiver profiles could predict subsequent service use. In addition, non-personal (e.g. meals on wheels) and supportive services (e.g. Alzheimer café) in early dementia were investigated as predictors.Methods: A total of 451 dyads of people with dementia and their informal caregivers from eight European countries were followed for one year. People were included if they did not use formal (personal) care but were expected to do so within 1 year. Logistic regression analyses were used with four clusters of service use as dependent variables (home social care, home personal care, day care and admission). The independent variables were caregiver profiles, and non-personal and supportive services at baseline.Results: Caregiver profiles were significant predictors of service use; those experiencing high strain were more likely to use formal care. The use of low-intensity, less intrusive services at baseline significantly predicted the use of home personal care and admission at follow-up. The use of day care at follow-up was predicted by the baseline use of supportive services.Conclusion: Caregiver profiles are valuable predictors for service use: this knowledge can aid professionals in ensuring optimal access to services, which is important for maintaining independence at home. In addition, the use of supportive and less intrusive, non-personal services in the early stages of dementia is to be advised.
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Affiliation(s)
- Liselot Kerpershoek
- Alzheimer Centre Limburg, Maastricht, Netherlands.,Maastricht University, Maastricht, Netherlands
| | | | - Claire Wolfs
- Alzheimer Centre Limburg, Maastricht, Netherlands.,Maastricht University, Maastricht, Netherlands
| | - Frans Verhey
- Alzheimer Centre Limburg, Maastricht, Netherlands.,Maastricht University, Maastricht, Netherlands
| | | | - Anja Bieber
- Martin-Luther University Halle-Wittenberg, Halle, Germany
| | - Astrid Stephan
- Martin-Luther University Halle-Wittenberg, Halle, Germany
| | - Mona Michelet
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital, Tonsberg, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Geir Selbaek
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital, Tonsberg, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway.,Centre for Old Age Psychiatry Research, Innlandet Hospital Trust, Ottestad, Norway
| | - Ron Handels
- Alzheimer Centre Limburg, Maastricht, Netherlands.,Maastricht University, Maastricht, Netherlands.,Department of Neurobiology, Care sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Anders Wimo
- Department of Neurobiology, Care sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Louise Hopper
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - Kate Irving
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - Maria J Marques
- Nova Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, CEDOC, Lisboa, Portugal
| | - Manuel Gonçalves-Pereira
- Nova Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, CEDOC, Lisboa, Portugal
| | - Elisa Portolani
- Alzheimer's Research Unit-Memory Clinic, IRCCS "Centro S. Giovanni di Dio, Brescia, Italy
| | - Orazio Zanetti
- Alzheimer's Research Unit-Memory Clinic, IRCCS "Centro S. Giovanni di Dio, Brescia, Italy
| | - Marjolein de Vugt
- Alzheimer Centre Limburg, Maastricht, Netherlands.,Maastricht University, Maastricht, Netherlands
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3
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O'Shea E, Hopper L, Marques M, Gonçalves-Pereira M, Woods B, Jelley H, Verhey F, Kerpershoek L, Wolfs C, de Vugt M, Stephan A, Bieber A, Meyer G, Wimo A, Michelet M, Selbaek G, Portolani E, Zanetti O, Irving K. A comparison of self and proxy quality of life ratings for people with dementia and their carers: a European prospective cohort study. Aging Ment Health 2020; 24:162-170. [PMID: 30381955 DOI: 10.1080/13607863.2018.1517727] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Objectives: To identify correlates of self-rated and proxy-rated quality of life (QoL) in people with dementia on (i) a dementia-specific and (ii) a capability-wellbeing QoL measure at baseline and 12-month follow-up, and to consider such factors in the context of QoL intervention development.Method: Prospective clinical and demographic data were collected from 451 community-dwelling dyads (mild-moderate dementia) across eight European countries. QoL was measured using the QOL-AD and the ICECAP-O. Multivariate modelling identified correlates of self- and proxy-rated QoL at baseline and at 12-month follow-up.Results: Carer's proxy-ratings of QoL were significantly lower than self-ratings at all time-points for both measures. Proxy-ratings declined over time, but self-ratings remained stable. Baseline predictors of greater self-rated QoL were education, and greater functional ability and relationship quality. Greater proxy-rated QoL was associated with education and greater functional ability, relationship quality, carer social support and carer QoL, lower carer anxiety/depression and less severe neuropsychiatric symptoms in people with dementia. At follow-up, greater self-rated QoL was predicted by greater functional ability, relationship quality, carer social support and having a spousal carer. Greater proxy-rated QoL at follow-up was associated with the same factors as at baseline; however, the dyad living together was an additional predictive factor.Conclusion: Both proxy-ratings and self-ratings of QoL should be interpreted with caution and in the context of each individual caregiving relationship. Different functional, psychosocial, relational and contextual factors influence self- and proxy-ratings, and both sets of factors should be considered in the context of QoL intervention development for the dyad.
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Affiliation(s)
- E O'Shea
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - L Hopper
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - M Marques
- CEDOC, Chronic Diseases Research Centre, Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
| | - M Gonçalves-Pereira
- CEDOC, Chronic Diseases Research Centre, Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
| | - B Woods
- Dementia Services Development Centre, Bangor University, Bangor, UK
| | - H Jelley
- Dementia Services Development Centre, Bangor University, Bangor, UK
| | - F Verhey
- School for Mental Health and Neuroscience, Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - L Kerpershoek
- School for Mental Health and Neuroscience, Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - C Wolfs
- School for Mental Health and Neuroscience, Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - M de Vugt
- School for Mental Health and Neuroscience, Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - A Stephan
- Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - A Bieber
- Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - G Meyer
- Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - A Wimo
- Department of Neurobiology, Care sciences and Society, Karolinska Institut, Stockholm, Sweden
| | - M Michelet
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - G Selbaek
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - E Portolani
- Alzheimer's Research Unit-Memory Clinic, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - O Zanetti
- Alzheimer's Research Unit-Memory Clinic, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - K Irving
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
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4
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Marques MJ, Woods B, Hopper L, Jelley H, Irving K, Kerpershoek L, Meyer G, Bieber A, Stephan A, Sköldunger A, Sjölund BM, Selbaek G, Rosvik J, Zanetti O, Portolani E, de Vugt M, Verhey F, Gonçalves-Pereira M. Relationship quality and sense of coherence in dementia: Results of a European cohort study. Int J Geriatr Psychiatry 2019; 34:745-755. [PMID: 30729572 DOI: 10.1002/gps.5082] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 02/03/2019] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Quality of life of people with dementia and their family carers is strongly influenced by interpersonal issues and personal resources. In this context, relationship quality (RQ) and sense of coherence (SOC) potentially protect and promote health. We aimed to identify what influences RQ in dyads of people with dementia and their carers and to examine differences in their perspectives. METHODS Cross-sectional data were used from the Actifcare cohort study of 451 community-dwelling people with dementia and their primary carers in eight European countries. Comprehensive assessments included the Positive Affect Index (RQ) and the Orientation to Life Questionnaire (SOC). RESULTS Regression analyses revealed that RQ as perceived by people with dementia was associated with carer education, stress, and spouse caregiving. RQ as perceived by carers was associated with carer stress, depression, being a spouse, social support, reported neuropsychiatric symptoms of dementia, and carer SOC. Neuropsychiatric symptoms and carer stress contributed to discrepancies in RQ ratings within the dyad. The only factor associated with both individual RQ ratings and discrepancies was carer stress (negative feelings subscore). No significant differences in the overall perception of RQ were evident between spouses and adult children carers, but RQ determinants differed between the two. CONCLUSIONS In this European sample, carer SOC was associated with carer-reported RQ. RQ determinants differed according to the perspective considered (person with dementia or carer) and carer subgroup. A deeper understanding of RQ and its determinants will help to tailor interventions that address these distinct perspectives and potentially improve dementia outcomes.
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Affiliation(s)
- Maria J Marques
- CEDOC, NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Bob Woods
- Dementia Services Development Centre (DSDC) Wales, Bangor University, Bangor, UK
| | - Louise Hopper
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - Hannah Jelley
- Dementia Services Development Centre (DSDC) Wales, Bangor University, Bangor, UK
| | - Kate Irving
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - Liselot Kerpershoek
- Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Gabriele Meyer
- Institute for Health and Nursing Science, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Anja Bieber
- Institute for Health and Nursing Science, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Astrid Stephan
- Institute for Health and Nursing Science, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Anders Sköldunger
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Britt-Marie Sjölund
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Health and Caring Sciences, University of Gävle, Gävle, Sweden
| | - Geir Selbaek
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway.,Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway
| | - Janne Rosvik
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Orazio Zanetti
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Elisa Portolani
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Marjolein de Vugt
- Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Frans Verhey
- Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Manuel Gonçalves-Pereira
- CEDOC, NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
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5
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Janssen N, Handels RL, Sköldunger A, Woods B, Jelley H, Edwards RT, Orrell M, Selbæk G, Røsvik J, Gonçalves-Pereira M, Marques MJ, Zanetti O, Portolani E, Irving K, Hopper L, Meyer G, Bieber A, Stephan A, Kerpershoek L, Wolfs CA, de Vugt ME, Verhey FR, Wimo A. Impact of Untimely Access to Formal Care on Costs and Quality of Life in Community Dwelling People with Dementia. J Alzheimers Dis 2018; 66:1165-1174. [DOI: 10.3233/jad-180531] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Niels Janssen
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Ron L. Handels
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Neurobiology, Care sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Anders Sköldunger
- Department of Neurobiology, Care sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Bob Woods
- Dementia Services Development Centre, Bangor University, Bangor, UK
| | - Hannah Jelley
- Dementia Services Development Centre, Bangor University, Bangor, UK
| | - Rhiannon Tudor Edwards
- Centre for Health Economics and Medicines Evaluation (CHEME), Bangor University, Bangor, UK
| | - Martin Orrell
- Nottingham University, Institute of Mental Health, Nottingham, UK
| | - Geir Selbæk
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, T—nsberg, Norway
| | - Janne Røsvik
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, T—nsberg, Norway
| | - Manuel Gonçalves-Pereira
- CEDOC, Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Maria J. Marques
- CEDOC, Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Orazio Zanetti
- Alzheimer’s Research Unit – Memory Clinic – IRCCS Centro S.Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Elisa Portolani
- Alzheimer’s Research Unit – Memory Clinic – IRCCS Centro S.Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Kate Irving
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - Louise Hopper
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - Gabriele Meyer
- Martin Luther University Halle-Wittenberg, Medical Faculty, Institute of Health and Nursing Sciences, Halle, Germany
| | - Anja Bieber
- Martin Luther University Halle-Wittenberg, Medical Faculty, Institute of Health and Nursing Sciences, Halle, Germany
| | - Astrid Stephan
- Martin Luther University Halle-Wittenberg, Medical Faculty, Institute of Health and Nursing Sciences, Halle, Germany
| | - Liselot Kerpershoek
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Claire A.G. Wolfs
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Marjolein E. de Vugt
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Frans R.J. Verhey
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Anders Wimo
- Department of Neurobiology, Care sciences and Society, Karolinska Institutet, Stockholm, Sweden
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Handels RL, Sköldunger A, Bieber A, Edwards RT, Gonçalves-Pereira M, Hopper L, Irving K, Jelley H, Kerpershoek L, Marques MJ, Meyer G, Michelet M, Portolani E, Røsvik J, Selbaek G, Stephan A, de Vugt M, Wolfs C, Woods B, Zanetti O, Verhey F, Wimo A. Quality of Life, Care Resource Use, and Costs of Dementia in 8 European Countries in a Cross-Sectional Cohort of the Actifcare Study. J Alzheimers Dis 2018; 66:1027-1040. [DOI: 10.3233/jad-180275] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Ron L.H. Handels
- Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands
- Department of Neurobiology, Care Science and Society, Division of Neurogeriatrics, Karolinska Institute, Stockholm, Sweden
| | - Anders Sköldunger
- Department of Neurobiology, Care Science and Society, Division of Neurogeriatrics, Karolinska Institute, Stockholm, Sweden
| | - Anja Bieber
- Martin Luther University Halle-Wittenberg, Medical Faculty, Institute for Health and Nursing Science, Halle (Saale), Germany
| | - Rhiannon Tudor Edwards
- Centre for Health Economics and Medicines Evaluation, Bangor University, Bangor, United Kingdom
| | - Manuel Gonçalves-Pereira
- CEDOC, Chronic Diseases Research Centre, NOVA Medical School/Faculdade de Ci—-ncias Médicas, Universidade Nova de Lisboa, Portugal
| | - Louise Hopper
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - Kate Irving
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - Hannah Jelley
- Dementia Services Development Centre Wales (DSDC), Bangor University, Bangor, United Kingdom
| | - Liselot Kerpershoek
- Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands
| | - Maria J. Marques
- CEDOC, Chronic Diseases Research Centre, NOVA Medical School/Faculdade de Ci—-ncias Médicas, Universidade Nova de Lisboa, Portugal
| | - Gabriele Meyer
- Martin Luther University Halle-Wittenberg, Medical Faculty, Institute for Health and Nursing Science, Halle (Saale), Germany
| | - Mona Michelet
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Health Trust, T—–nsberg, Norway
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Norway
| | - Elisa Portolani
- Alzheimer’s Unit - Memory Clinic, IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Janne Røsvik
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Health Trust, T—–nsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Norway
| | - Geir Selbaek
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Health Trust, T—–nsberg, Norway
- Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway
- Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Astrid Stephan
- Martin Luther University Halle-Wittenberg, Medical Faculty, Institute for Health and Nursing Science, Halle (Saale), Germany
| | - Marjolein de Vugt
- Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands
| | - Claire Wolfs
- Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands
| | - Bob Woods
- Dementia Services Development Centre Wales (DSDC), Bangor University, Bangor, United Kingdom
| | - Orazio Zanetti
- Alzheimer’s Unit - Memory Clinic, IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Frans Verhey
- Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands
| | - Anders Wimo
- Department of Neurobiology, Care Science and Society, Division of Neurogeriatrics, Karolinska Institute, Stockholm, Sweden
- Centre for Research & Development, Uppsala University/County Council of Gävleborg, Gävle, Sweden
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7
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Kerpershoek L, de Vugt M, Wolfs C, Woods B, Jelley H, Orrell M, Stephan A, Bieber A, Meyer G, Selbaek G, Handels R, Wimo A, Hopper L, Irving K, Marques M, Gonçalves-Pereira M, Portolani E, Zanetti O, Verhey F. Needs and quality of life of people with middle-stage dementia and their family carers from the European Actifcare study. When informal care alone may not suffice. Aging Ment Health 2018; 22:897-902. [PMID: 29068697 DOI: 10.1080/13607863.2017.1390732] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE The Actifcare (Access to timely formal care) study investigated needs of people with dementia and their families during the phase in which formal care is being considered, and examined whether higher need levels are related to lower quality of life (QOL). METHOD From eight European countries 451 people with dementia and their carers participated. Needs were measured with the Camberwell Assessment of Need for the Elderly. QOL was measured with the QOL-AD, and carer quality of life was measured with the CarerQol. The relationship between needs and QOL was analysed with multiple regression analyses. RESULTS Needs were expressed in the domains of psychological distress, daytime activities, company and information. People with dementia rated their unmet needs significantly lower than their carers: the mean number of self-rated unmet needs was 0.95, whereas the mean proxy ratings were 1.66. For met needs, the self-rated mean was 5.5 and was 8 when proxy-rated. The level of needs reported was negatively associated with QOL for both. CONCLUSION The study results show that informal carers reported almost twice as many needs as people with dementia. The domains in which needs are expressed should be the primary focus for interventions to support QOL. The perspectives of people with dementia are informative when identifying needs.
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Affiliation(s)
- Liselot Kerpershoek
- a Alzheimer Centrum Limburg , Maastricht University , Maastricht , The Netherlands
| | - Marjolein de Vugt
- a Alzheimer Centrum Limburg , Maastricht University , Maastricht , The Netherlands
| | - Claire Wolfs
- a Alzheimer Centrum Limburg , Maastricht University , Maastricht , The Netherlands
| | | | | | | | - Astrid Stephan
- c Martin Luther University Halle-Wittenberg (DE) , Institute of Health and Nursing sciences , Halle , Germany
| | - Anja Bieber
- c Martin Luther University Halle-Wittenberg (DE) , Institute of Health and Nursing sciences , Halle , Germany
| | - Gabriele Meyer
- c Martin Luther University Halle-Wittenberg (DE) , Institute of Health and Nursing sciences , Halle , Germany
| | - Geir Selbaek
- d Department of Geriatric Medicine , Oslo University Hospital , Oslo , Norway
| | - Ron Handels
- a Alzheimer Centrum Limburg , Maastricht University , Maastricht , The Netherlands.,e Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics , Karolinska Institutet , Stockholm , Sweden
| | - Anders Wimo
- e Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics , Karolinska Institutet , Stockholm , Sweden.,f Centre for Research & Development Uppsala University / City Council of Gävleborg , Gävle , Sweden
| | - Louise Hopper
- g School of Nursing and Human Sciences , Dublin City University , Dublin , Ireland
| | - Kate Irving
- g School of Nursing and Human Sciences , Dublin City University , Dublin , Ireland
| | - Maria Marques
- h CEDOC, Nova Medical School, Faculdade De Ciências Médicas , Universidade Nova De Lisboa , Lisbon , Portugal
| | - Manuel Gonçalves-Pereira
- h CEDOC, Nova Medical School, Faculdade De Ciências Médicas , Universidade Nova De Lisboa , Lisbon , Portugal
| | - Elisa Portolani
- i Alzheimer's Research Unit-Memory Clinic , IRCCS Centro S. Giovanni di Dio , Milano , Italy
| | - Orazio Zanetti
- i Alzheimer's Research Unit-Memory Clinic , IRCCS Centro S. Giovanni di Dio , Milano , Italy
| | - Frans Verhey
- a Alzheimer Centrum Limburg , Maastricht University , Maastricht , The Netherlands
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Stephan A, Bieber A, Hopper L, Joyce R, Irving K, Zanetti O, Portolani E, Kerpershoek L, Verhey F, de Vugt M, Wolfs C, Eriksen S, Røsvik J, Marques MJ, Gonçalves-Pereira M, Sjölund BM, Jelley H, Woods B, Meyer G. Barriers and facilitators to the access to and use of formal dementia care: findings of a focus group study with people with dementia, informal carers and health and social care professionals in eight European countries. BMC Geriatr 2018; 18:131. [PMID: 29866102 PMCID: PMC5987478 DOI: 10.1186/s12877-018-0816-1] [Citation(s) in RCA: 119] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Accepted: 05/14/2018] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND People with dementia and informal carers often access formal care late in the process of dementia. The barriers and facilitators to service use from the perspectives of different stakeholders involved are not well understood. Thus, we aimed to explore the barriers and facilitators of access to and utilisation of formal care from the perspectives of people with dementia, their informal carers and health and social care professionals. METHOD Focus groups with people with dementia, informal carers and professionals were conducted in eight European countries. Recruitment targeted people with dementia, informal carers with experience of formal care and professionals involved in providing (access to) formal care. Qualitative content analysis using open coding was used on a national level. Cross-national synthesis was based on the translated national reports. RESULTS Overall, 55 focus groups with 261 participants were conducted, involving 51 people with dementia, 96 informal carers and 114 professionals. Sixteen categories describing barriers and facilitators were identified, referring to three global themes: Aspects related to 1) individuals involved, 2) the system or 3) overarching aspects. The attitudes and beliefs of people with dementia and their carers may have a major impact, and they often serve as barriers. Formal care was perceived as a threat to the individual independence of people with dementia and was thus avoided as long as possible. A healthcare professional serving as a constant key contact person could be an essential facilitator to overcome these barriers. Contact should be initiated proactively, as early as possible, and a trusting and consistent relationship needs to be established. Beyond that, the findings largely confirm former research and show that barriers to accessing and using formal care still exist across Europe despite a number of national and European initiatives. CONCLUSION Further investigations are needed to elaborate how the concept of a key contact person could be integrated with existing case management approaches and how the independence and autonomy of people with dementia can be strengthened when formal care needs to be accessed and used. These may be meaningful facilitators regarding enhanced access to formal care for people with dementia and their families.
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Affiliation(s)
- Astrid Stephan
- Institute for Health and Nursing Science, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany.
| | - Anja Bieber
- Institute for Health and Nursing Science, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany
| | - Louise Hopper
- School of Nursing and Human Sciences, Dublin City University, Glasnevin, Dublin 9, Ireland
| | - Rachael Joyce
- School of Nursing and Human Sciences, Dublin City University, Glasnevin, Dublin 9, Ireland
| | - Kate Irving
- School of Nursing and Human Sciences, Dublin City University, Glasnevin, Dublin 9, Ireland
| | - Orazio Zanetti
- Alzheimer Unit, IRCCS S. Centro Giovanni di Dio "Fatebenefratelli", Via Pilastroni 4, Brescia (BS), Italy
| | - Elisa Portolani
- Alzheimer Unit, IRCCS S. Centro Giovanni di Dio "Fatebenefratelli", Via Pilastroni 4, Brescia (BS), Italy
| | - Liselot Kerpershoek
- Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Frans Verhey
- Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Marjolein de Vugt
- Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Claire Wolfs
- Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Siren Eriksen
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Janne Røsvik
- Department of Geriatric Medicine, Oslo University Hospital, Aldring og Helse, Oslo, Norway
| | - Maria J Marques
- Chronic Diseases Research Center, Nova Medical School
- Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo Mártires da Pátria, 130, 1169-056, Lisbon, Portugal
| | - Manuel Gonçalves-Pereira
- Chronic Diseases Research Center, Nova Medical School
- Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo Mártires da Pátria, 130, 1169-056, Lisbon, Portugal
| | - Britt-Marie Sjölund
- Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, University of Gävle, Gävle, Sweden
| | - Hannah Jelley
- Dementia Services Development Centre Wales, Bangor University, Bangor, LL57 2PZ, UK
| | - Bob Woods
- Dementia Services Development Centre Wales, Bangor University, Bangor, LL57 2PZ, UK
| | - Gabriele Meyer
- Institute for Health and Nursing Science, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany.
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9
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Broda A, Bieber A, Meyer G, Hopper L, Joyce R, Irving K, Zanetti O, Portolani E, Kerpershoek L, Verhey F, Vugt MD, Wolfs C, Eriksen S, Røsvik J, Marques MJ, Gonçalves-Pereira M, Sjölund BM, Woods B, Jelley H, Orrell M, Stephan A. Perspectives of policy and political decision makers on access to formal dementia care: expert interviews in eight European countries. BMC Health Serv Res 2017; 17:518. [PMID: 28774307 PMCID: PMC5543593 DOI: 10.1186/s12913-017-2456-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 07/18/2017] [Indexed: 11/10/2022] Open
Abstract
Background As part of the ActifCare (ACcess to Timely Formal Care) project, we conducted expert interviews in eight European countries with policy and political decision makers, or representatives of relevant institutions, to determine their perspectives on access to formal care for people with dementia and their carers. Methods Each ActifCare country (Germany, Ireland, Italy, The Netherlands, Norway, Portugal, Sweden, United Kingdom) conducted semi-structured interviews with 4–7 experts (total N = 38). The interview guide addressed the topics “Complexity and Continuity of Care”, “Formal Services”, and “Public Awareness”. Country-specific analysis of interview transcripts used an inductive qualitative content analysis. Cross-national synthesis focused on similarities in themes across the ActifCare countries. Results The analysis revealed ten common themes and two additional sub-themes across countries. Among others, the experts highlighted the need for a coordinating role and the necessity of information to address issues of complexity and continuity of care, demanded person-centred, tailored, and multidisciplinary formal services, and referred to education, mass media and campaigns as means to raise public awareness. Conclusions Policy and political decision makers appear well acquainted with current discussions among both researchers and practitioners of possible approaches to improve access to dementia care. Experts described pragmatic, realistic strategies to influence dementia care. Suggested innovations concerned how to achieve improved dementia care, rather than transforming the nature of the services provided. Knowledge gained in these expert interviews may be useful to national decision makers when they consider reshaping the organisation of dementia care, and may thus help to develop best-practice strategies and recommendations. Electronic supplementary material The online version of this article (doi:10.1186/s12913-017-2456-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anja Broda
- Martin Luther University Halle-Wittenberg, Institute of Health and Nursing Sciences, Magdeburger Straße 8, D-06112, Halle (Saale), Germany.
| | - Anja Bieber
- Martin Luther University Halle-Wittenberg, Institute of Health and Nursing Sciences, Magdeburger Straße 8, D-06112, Halle (Saale), Germany
| | - Gabriele Meyer
- Martin Luther University Halle-Wittenberg, Institute of Health and Nursing Sciences, Magdeburger Straße 8, D-06112, Halle (Saale), Germany
| | - Louise Hopper
- Dublin City University, School of Nursing and Human Sciences, Dublin, Ireland
| | - Rachael Joyce
- Dublin City University, School of Nursing and Human Sciences, Dublin, Ireland
| | - Kate Irving
- Dublin City University, School of Nursing and Human Sciences, Dublin, Ireland
| | - Orazio Zanetti
- IRCCS S. Giovanni di Dio "Fatebenefratelli", Brescia, Italy
| | | | - Liselot Kerpershoek
- Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Frans Verhey
- Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Marjolein de Vugt
- Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Claire Wolfs
- Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Siren Eriksen
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Oslo, Norway
| | - Janne Røsvik
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Oslo, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Maria J Marques
- CEDOC, Chronic Diseases Research Center, Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Manuel Gonçalves-Pereira
- CEDOC, Chronic Diseases Research Center, Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Britt-Marie Sjölund
- Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, University of Gävle, Gävle, Sweden
| | - Bob Woods
- Bangor University, Dementia Services Development Centre, Bangor, UK
| | - Hannah Jelley
- Bangor University, Dementia Services Development Centre, Bangor, UK
| | - Martin Orrell
- Nottingham University, Institute of Mental Health, Nottingham, UK
| | - Astrid Stephan
- Martin Luther University Halle-Wittenberg, Institute of Health and Nursing Sciences, Magdeburger Straße 8, D-06112, Halle (Saale), Germany
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10
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Bieber A, Stephan A, Verbeek H, Verhey F, Kerpershoek L, Wolfs C, de Vugt M, Woods RT, Røsvik J, Selbaek G, Sjölund BM, Wimo A, Hopper L, Irving K, Marques MJ, Gonçalves-Pereira M, Portolani E, Zanetti O, Meyer G. 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. Z Gerontol Geriatr 2017; 51:530-536. [PMID: 28616816 DOI: 10.1007/s00391-017-1266-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 04/12/2017] [Accepted: 05/29/2017] [Indexed: 01/16/2023]
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.
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Affiliation(s)
- A Bieber
- Medical Faculty, Institute for Health and Nursing Science, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany
| | - A Stephan
- Medical Faculty, Institute for Health and Nursing Science, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany
| | - H Verbeek
- School for Mental Health and Neuroscience, Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - F Verhey
- School for Mental Health and Neuroscience, Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - L Kerpershoek
- School for Mental Health and Neuroscience, Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - C Wolfs
- School for Mental Health and Neuroscience, Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - M de Vugt
- School for Mental Health and Neuroscience, Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - R T Woods
- Dementia Services Development Centre Wales, Bangor University, Bangor, UK
| | - J Røsvik
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, and Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - G Selbaek
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, and Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - B M Sjölund
- Department of Neurobiology, Care sciences and Society, Karolinska Institut, Stockholm, Sweden.,Department of Health and Caring Services, University of Gävle, Gävle, Sweden
| | - A Wimo
- Department of Neurobiology, Care sciences and Society, Karolinska Institut, Stockholm, Sweden
| | - L Hopper
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - K Irving
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - M J Marques
- CEDOC, Chronic Diseases Research Centre, Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - M Gonçalves-Pereira
- CEDOC, Chronic Diseases Research Centre, Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - E Portolani
- Alzheimer's Research Unit-Memory Clinic, Brescia, Italy
| | - O Zanetti
- Alzheimer's Research Unit-Memory Clinic, Brescia, Italy
| | - G Meyer
- Medical Faculty, Institute for Health and Nursing Science, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany.
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11
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Janssen EPCJ, de Vugt M, Köhler S, Wolfs C, Kerpershoek L, Handels RLH, Orrell M, Woods B, Jelley H, Stephan A, Bieber A, Meyer G, Engedal K, Selbaek G, Wimo A, Irving K, Hopper L, Gonçalves-Pereira M, Portolani E, Zanetti O, Verhey FR. Caregiver profiles in dementia related to quality of life, depression and perseverance time in the European Actifcare study: the importance of social health. Aging Ment Health 2017; 21:49-57. [PMID: 27869480 DOI: 10.1080/13607863.2016.1255716] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To identify caregiver profiles of persons with mild to moderate dementia and to investigate differences between identified caregiver profiles, using baseline data of the international prospective cohort study Actifcare. METHODS A latent class analysis was used to discover different caregiver profiles based on disease related characteristics of 453 persons with dementia and their 453 informal caregivers. These profiles were compared with regard to quality of life (CarerQoL score), depressive symptoms (HADS-D score) and perseverance time. RESULTS A 5-class model was identified, with the best Bayesian Information Criterion value, significant likelihood ratio test (p < 0.001), high entropy score (0.88) and substantive interpretability. The classes could be differentiated on two axes: (i) caregivers' age, relationship with persons with dementia, severity of dementia, and (ii) tendency towards stress and difficulty adapting to stress. Classes showed significant differences with all dependent variables, and were labelled 'older low strain', 'older intermediate strain', 'older high strain', 'younger low strain' and 'younger high strain'. CONCLUSION Differences exist between types of caregivers that explain variability in quality of life, depressive symptoms and perseverance time. Our findings may give direction for tailored interventions for caregivers of persons with dementia, which may improve social health and reduce health care costs.
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Affiliation(s)
- Eveline P C J Janssen
- a Department of Psychiatry and Neuropsychology , School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center , Maastricht , The Netherlands.,b Department of Old Age Psychiatry , Mondriaan , Heerlen , The Netherlands
| | - Marjolein de Vugt
- a Department of Psychiatry and Neuropsychology , School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center , Maastricht , The Netherlands
| | - Sebastian Köhler
- a Department of Psychiatry and Neuropsychology , School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center , Maastricht , The Netherlands
| | - Claire Wolfs
- a Department of Psychiatry and Neuropsychology , School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center , Maastricht , The Netherlands
| | - Liselot Kerpershoek
- a Department of Psychiatry and Neuropsychology , School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center , Maastricht , The Netherlands
| | - Ron L H Handels
- a Department of Psychiatry and Neuropsychology , School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center , Maastricht , The Netherlands
| | - Martin Orrell
- c Department of Psychiatry and Applied Psychology, Faculty of Medicine & Health Sciences , Institute of Mental Health, University of Nottingham , Nottingham , United Kingdom
| | - Bob Woods
- d Dementia Services Development Centre Wales , Bangor University , Bango , United Kingdom
| | - Hannah Jelley
- d Dementia Services Development Centre Wales , Bangor University , Bango , United Kingdom
| | - Astrid Stephan
- e Medical Faculty , Institute for Health and Nursing Science , Halle-Wittenberg , Germany
| | - Anja Bieber
- e Medical Faculty , Institute for Health and Nursing Science , Halle-Wittenberg , Germany
| | - Gabriele Meyer
- e Medical Faculty , Institute for Health and Nursing Science , Halle-Wittenberg , Germany
| | - Knut Engedal
- f Norwegian National Advisory Unit on Ageing and Health , Vestfold Hospital Trust , Tønsberg , Norway
| | - Geir Selbaek
- f Norwegian National Advisory Unit on Ageing and Health , Vestfold Hospital Trust , Tønsberg , Norway
| | - Anders Wimo
- g Department of Neurobiology, Care sciences and Society , Karolinska Institut , Stockholm , Sweden
| | - Kate Irving
- h School of Nursing and Human Sciences, Dublin City University , Dublin , Ireland
| | - Louise Hopper
- h School of Nursing and Human Sciences, Dublin City University , Dublin , Ireland
| | - Manuel Gonçalves-Pereira
- i CEDOC - Chronic Diseases Research Center , Nova Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa , Lisbon , Portugal
| | - Elisa Portolani
- j Alzheimer Unit , IRCCS Centro San Giovanni di Dio, Fatebenefratelli , Brescia , Italy
| | - Orazio Zanetti
- j Alzheimer Unit , IRCCS Centro San Giovanni di Dio, Fatebenefratelli , Brescia , Italy
| | - Frans R Verhey
- a Department of Psychiatry and Neuropsychology , School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center , Maastricht , The Netherlands
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12
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Kerpershoek L, de Vugt M, Wolfs C, Jelley H, Orrell M, Woods B, Stephan A, Bieber A, Meyer G, Engedal K, Selbaek G, Handels R, Wimo A, Hopper L, Irving K, Marques M, Gonçalves-Pereira M, Portolani E, Zanetti O, Verhey F. Erratum to: Access to timely formal dementia care in Europe: protocol of the Actifcare (ACcess to Timely Formal Care) study. BMC Health Serv Res 2016; 16:620. [PMID: 27793151 PMCID: PMC5086073 DOI: 10.1186/s12913-016-1877-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 10/25/2016] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | | | | | | | | | - Astrid Stephan
- Martin-Luther University Halle-Wittenberg, Halle, Germany
| | - Anja Bieber
- Martin-Luther University Halle-Wittenberg, Halle, Germany
| | - Gabriele Meyer
- Martin-Luther University Halle-Wittenberg, Halle, Germany
| | | | | | - Ron Handels
- Maastricht University, Maastricht, Netherlands.,Karolinska Institutet, Solna, Sweden
| | | | | | | | - Maria Marques
- CEDOC, Nova Medical School
- Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Manuel Gonçalves-Pereira
- CEDOC, Nova Medical School
- Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Elisa Portolani
- Alzheimer's Research Unit-Memory Clinic, IRCCS "Centro S.Giovanni di Dio, Brescia, Italy
| | - Orazio Zanetti
- Alzheimer's Research Unit-Memory Clinic, IRCCS "Centro S.Giovanni di Dio, Brescia, Italy
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13
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Kerpershoek L, de Vugt M, Wolfs C, Jelley H, Orrell M, Woods B, Stephan A, Bieber A, Meyer G, Engedal K, Selbaek G, Handels R, Wimo A, Hopper L, Irving K, Marques M, Gonçalves-Pereira M, Portolani E, Zanetti O, Verhey F. Access to timely formal dementia care in Europe: protocol of the Actifcare (ACcess to Timely Formal Care) study. BMC Health Serv Res 2016; 16:423. [PMID: 27550084 PMCID: PMC4994155 DOI: 10.1186/s12913-016-1672-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 08/15/2016] [Indexed: 11/16/2022] Open
Abstract
Background Previous findings indicate that people with dementia and their informal carers experience difficulties accessing and using formal care services due to a mismatch between needs and service use. This mismatch causes overall dissatisfaction and is a waste of the scarce financial care resources. This article presents the background and methods of the Actifcare (ACcess to Timely Formal Care) project. This is a European study aiming at best-practice development in finding timely access to formal care for community-dwelling people with dementia and their informal carers. There are five main objectives: 1) Explore predisposing and enabling factors associated with the use of formal care, 2) Explore the association between the use of formal care, needs and quality of life and 3) Compare these across European countries, 4) Understand the costs and consequences of formal care services utilization in people with unmet needs, 5) Determine the major costs and quality of life drivers and their relationship with formal care services across European countries. Methods In a longitudinal cohort study conducted in eight European countries approximately 450 people with dementia and informal carers will be assessed three times in 1 year (baseline, 6 and 12 months). In this year we will closely monitor the process of finding access to formal care. Data on service use, quality of life and needs will be collected. Discussion The results of Actifcare are expected to reveal best-practices in organizing formal care. Knowledge about enabling and predisposing factors regarding access to care services, as well as its costs and consequences, can advance the state of the art in health systems research into pathways to dementia care, in order to benefit people with dementia and their informal carers.
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Affiliation(s)
| | | | | | | | | | | | - Astrid Stephan
- Martin-Luther University Halle-Wittenberg, Halle, Germany
| | - Anja Bieber
- Martin-Luther University Halle-Wittenberg, Halle, Germany
| | - Gabriele Meyer
- Martin-Luther University Halle-Wittenberg, Halle, Germany
| | | | | | - Ron Handels
- Maastricht University, Maastricht, Netherlands.,Karolinska Institutet, Solna, Sweden
| | | | | | | | - Maria Marques
- CEDOC, Nova Medical School
- Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Manuel Gonçalves-Pereira
- CEDOC, Nova Medical School
- Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Elisa Portolani
- Alzheimer's Research Unit-Memory Clinic, IRCCS "Centro S.Giovanni di Dio, Brescia, Italy
| | - Orazio Zanetti
- Alzheimer's Research Unit-Memory Clinic, IRCCS "Centro S.Giovanni di Dio, Brescia, Italy
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Pignatti R, Bertella L, Scarpina F, Mauro A, Portolani E, Calabrese P. Italian Version of the Parkinson Neuropsychometric Dementia Assessment (PANDA): A Useful Instrument to Detect Cognitive Impairments in Parkinson's Disease. Journal of Parkinson's Disease 2014; 4:151-60. [DOI: 10.3233/jpd-130270] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Riccardo Pignatti
- Neurocentro della Svizzera Italiana, Ente Ospedaliero Cantonale, Lugano, TI, Switzerland
| | - Laura Bertella
- Unità operativa di neuropsicologia e logopedia, Clinica Hildebrand, Centro di Riabilitazione Brissago, TI, Switzerland
| | - Federica Scarpina
- Laboratory of Psychology, IRCCS Istituto Auxologico Italiano, Piancavallo, VB, Italy
| | - Alessandro Mauro
- Division of Neurology and Neuro-Rehabilitation, IRCCS Istituto Auxologico Italiano, Piancavallo, VB, Italy Department of Neurosciences, University of Turin, Italy
| | - Elisa Portolani
- Department of Psychology, Università Cattolica del Sacro Cuore, Milano, Italy
| | - Pasquale Calabrese
- Division of molecular and cognitive neuroscience, University of Basel, BS, Switzerland
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