Community-based dementia care re-defined: Lessons from Iceland

Margrét Guðnadóttir*, Christine Ceci, Marit Kirkevold, Kristín Björnsdóttir

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Studies of families caring for persons with dementia living at home often reflect feelings of being forgotten and abandoned by the authorities to shoulder the responsibility for care-giving. This has increased interest in how formal services can better support these families. This article analyses how health and social care professionals envision the needs of families of persons with dementia living in the community. It also describes the contributions of the formal care system to these families. The study design was qualitative. It involved interviews with professionals (N = 20), field observations from the settings where they worked, and public documents addressing care-giving for people with dementia. Data were analysed using the framework method. The findings reflected how those providing services to persons experiencing cognitive changes mainly understood the services as specialised. They focused on the diagnosis and treatment of the individual with dementia. They considered other aspects of care, such as attending to practical issues of daily life, to be a private matter, for which the family was responsible. In later stages of dementia, specialised day programs become available, offering rehabilitation to motivate positive daily living—for both the person experiencing dementia and family-centred supporters. Professionals in the field described primary care, community-based healthcare and home care services as poorly equipped to support these families. Participants acknowledged that families were often under a lot of stress and might need more support earlier in the illness. However, they saw themselves as powerless. Towards the end of the data collection, services were being re-designed to emphasise the role of primary care. In light of its holistic and family-centred approach, primary care may be well placed to integrate relational understanding of living with dementia and specialised knowledge of dementia treatment.

Original languageEnglish
Pages (from-to)1091-1099
Number of pages9
JournalHealth and Social Care in the Community
Volume29
Issue number4
DOIs
Publication statusPublished - 3 Sept 2020

Bibliographical note

Funding text
The overall project was funded by The Icelandic Gerontological Research Institute (RHLÖ) and The Icelandic Nurses' Association. There has been no funding for production of this manuscript.

Publisher Copyright:
© 2020 John Wiley & Sons Ltd

Other keywords

  • community care
  • dementia care
  • family care-giving
  • relational understanding

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