WORLD HEALTH ORGANIZATION. Regional Office for Europe
Publisher:
World Health Organization. Regional Office for Europe
Publication year:
2022
Pagination:
22
Place of publication:
Copenhagen
The pandemic of coronavirus disease 2019 has revealed and accentuated important gaps in the provision of appropriate, community-based, long-term care services for a rapidly growing number of people experiencing decline in functional ability, across the WHO European Region. As countries work to rebuild and strengthen health and long-term care systems, it is essential to support broad dialogue, a common vision for change and focused interventions to bridge existing divides. This policy brief proposes a conceptual framework that maps long-term care actions within the health and social policy landscape and highlights the need and potential for deeper integration and coordination across systems.
(Edited publisher abstract)
The pandemic of coronavirus disease 2019 has revealed and accentuated important gaps in the provision of appropriate, community-based, long-term care services for a rapidly growing number of people experiencing decline in functional ability, across the WHO European Region. As countries work to rebuild and strengthen health and long-term care systems, it is essential to support broad dialogue, a common vision for change and focused interventions to bridge existing divides. This policy brief proposes a conceptual framework that maps long-term care actions within the health and social policy landscape and highlights the need and potential for deeper integration and coordination across systems.
(Edited publisher abstract)
Subject terms:
long term care, policy, ageing, service provision, community care, social policy, models, older people, dementia;
Background and Objectives: Initiatives to create dementia-friendly environments are subject to political attention all over the world. As the interpretation of dementia-friendliness is influenced by current cultural trends, the concept is highly ambiguous. The present study aims to explore how discourses concerning dementia-friendliness are manifested in Danish and international policy documents...
(Edited publisher abstract)
Background and Objectives: Initiatives to create dementia-friendly environments are subject to political attention all over the world. As the interpretation of dementia-friendliness is influenced by current cultural trends, the concept is highly ambiguous. The present study aims to explore how discourses concerning dementia-friendliness are manifested in Danish and international policy documents and how they interact internationally. Research Design and Methods: Inspired by Fairclough’s critical discourse approach, 21 policy documents were analyzed to reveal how power is exerted through language and the discursive construction. Results: this study identified 5 types of discourses, namely, those concerning the domains of socioeconomy, rehabilitation, knowledge, responsibility, and a good life. Dementia-friendliness was found to be embedded in an overall ideology aimed toward supporting the individual’s autonomy in life and health choices and their participation in society. Discussion and Implications: this analysis furthermore suggests that dementia-friendly initiatives are used collectively as a lever to achieve these policy aims to ultimately compensate for and protect people with dementia against the consequences of the loss of competencies, identity, and control. Thus, to develop and establish sustainable dementia-friendly environments and communities that meet the needs of people living with dementia, we need to be aware of and discuss the implications of the discourses constructing dementia-friendliness and their influence on the appearance of dementia-friendliness in society.
(Edited publisher abstract)
Subject terms:
dementia, critical thinking, environment, policy, social policy;
Health and Social Care in the Community, early cite November 2021,
Publisher:
Wiley
...with dementia (PLWD) across the UK were recruited via convenience sampling and participated via telephone or online. Participants took part in a semi-structured remote interview. Data were collected between October and November 2020. Anonymised transcripts were analysed separately by two research team members using thematic analysis, with codes discussed and themes generated jointly, supported by research
(Edited publisher abstract)
Little is known on how the pandemic has changed care home care delivery. The aim of this study was to explore the impact of COVID-19 on care provision and visits in care homes from staff and family members’ perspectives. For this purpose, the researchers conducted a telephone- and zoom-based qualitative semi-structured interview study. Care home staff and family carers of people living with dementia (PLWD) across the UK were recruited via convenience sampling and participated via telephone or online. Participants took part in a semi-structured remote interview. Data were collected between October and November 2020. Anonymised transcripts were analysed separately by two research team members using thematic analysis, with codes discussed and themes generated jointly, supported by research team input. 42 participants (26 family carers and 16 care home staff) took part. Five themes were generated: (a) Care home reputation and financial implications; (b) Lack of care; (c) Communication or lack thereof; (d) Visiting rights/changes based on residents’ needs; (e) Deterioration of residents. With a lack of clear guidance throughout the pandemic, care homes delivered care differently with disparities in the levels and types of visiting allowed for family members. Lack of communication between care homes and family members, but also government and care homes, led to family carers feeling excluded and concerned about the well-being of their relative. Improved communication and clear guidance for care homes and the public are required to negate the potentially damaging effects of COVID-19 restrictions upon residents, their families and the carers who support them.
(Edited publisher abstract)
Subject terms:
care homes, Covid-19, staff views, carer views, qualitative research, family members, service provision, communication, policy, social exclusion, wellbeing;
Health and Social Care in the Community, 29(5), 2021, pp.e97-e106.
Publisher:
Wiley
...stakeholders working with and on behalf of these population groups understand, conceptualise and capitalise on the involvement of place in CLTs has not been investigated. This paper aims to address this deficit and explores the perspectives of key national and local actors on three CLTs - dementia, bereavement and forced migration - and their relationship with place and exclusion. The analysis involved 18
(Edited publisher abstract)
Major transitions in older people's lives can give rise to multifaceted forms of social exclusion, with subsequent impacts for later life health and well-being. With place now a central concept within policy on ageing and community care, there is the potential that it may offer new pathways to support older people undergoing these critical life transitions (CLTs). However, how policy and practice stakeholders working with and on behalf of these population groups understand, conceptualise and capitalise on the involvement of place in CLTs has not been investigated. This paper aims to address this deficit and explores the perspectives of key national and local actors on three CLTs - dementia, bereavement and forced migration - and their relationship with place and exclusion. The analysis involved 18 semi-structured interviews with stakeholders from policy, practice and advocacy spheres related to the CLTs and ageing in general. Interviews highlighted the differences across stakeholders in perceived exclusionary impacts, and the different degrees to which place is conceptualised in relation to these transitions. Findings illustrate the lack of a holistic policy approach to the needs of older people experiencing CLTs that impedes our capacity to truly harness place in supporting older people. The article concludes by arguing for a more nuanced reconstruction of place and its meanings in the context of CLTs.
(Edited publisher abstract)
Subject terms:
policy, social transitions, older people, place-based approach, social exclusion, staff views;
This practice note gives advice on how town planning can work with other professionals to create better environments for people living with dementia. It summarises expert advice, outlines key planning policy, good practice and case studies from around the UK. It also attempts to reflect on the challenges people living with dementia, their families and carers face, as a result of the Covid-19...
(Edited publisher abstract)
This practice note gives advice on how town planning can work with other professionals to create better environments for people living with dementia. It summarises expert advice, outlines key planning policy, good practice and case studies from around the UK. It also attempts to reflect on the challenges people living with dementia, their families and carers face, as a result of the Covid-19 pandemic, along with how the built environment can be adapted to improve their safety and support them to live independently in the future. Evidence has shown that good quality housing and well-planned, enabling local environments can have a substantial impact on the quality of life of someone living with dementia, helping them to live well for longer and of course, town planning has a key role to play if health and social care policies are to succeed. The document covers: impact of the built environment; home and dementia; what a place designed for people living with dementia looks like; legislation and policy; planning for dementia; and tools and approaches to plan for people living with dementia. This revised version includes new examples of good practice, along with updated information, advice and practice. The policy context applies to England, Scotland, Wales and Northern Ireland.
(Edited publisher abstract)
Subject terms:
Covid-19, dementia, environment, planning, urban areas, building design, buildings, housing, home adaptations, policy;
Journal of Social Policy, 49(3), 2020, pp.622-642.
Publisher:
Cambridge University Press
Place of publication:
Cambridge
Policy makers across the political spectrum have extolled the virtues of volunteering in achieving social policy aims. Yet little is known about the role that volunteering plays in addressing one of the significant challenges of an ageing population: the provision of care and support to people with dementia. This study combined organisational survey data, secondary social survey data...
(Edited publisher abstract)
Policy makers across the political spectrum have extolled the virtues of volunteering in achieving social policy aims. Yet little is known about the role that volunteering plays in addressing one of the significant challenges of an ageing population: the provision of care and support to people with dementia. This study combined organisational survey data, secondary social survey data, and in-depth interviews with people with dementia, family carers and volunteers in order to better understand the context, role and challenges in which volunteers support people with dementia. Social policies connecting volunteering and dementia care in homes and communities often remain separate and disconnected and this paper draws on the concept of policy ‘assemblages’ to suggest that dementia care is a dynamic mixture of formal and informal volunteering activities that bridge and blur traditional policy boundaries. Linking home and community environments is a key motivation, benefit and outcome for volunteers, carers and those living with dementia. The paper calls to widen the definition and investigation of volunteering in social policy to include and support informal volunteering activity.
(Edited publisher abstract)
Subject terms:
volunteers, dementia, housing, communities, voluntary sector, policy, social policy, motivation;
Journal of the American Medical Directors Association, 21(7), 2020, pp.900-904.
Publisher:
Elsevier (for the American Medical Directors Association)
Objectives: To prevent and control COVID-19 infections, nursing homes across the world have taken very restrictive measures, including a ban for visitors. These restrictive measures have an enormous impact on residents' well-being and pose dilemmas for staff, although primary data are lacking. A Dutch guideline was developed to cautiously open nursing homes for visitors during the COVID-19 pandemic. This study reports the first findings on how the guideline was applied in the local context; the compliance to local protocols; and the impact on well-being of residents, their family caregivers, and staff. Design: A mixed-methods cross-sectional study was conducted. Setting and Participants: In total, 26 nursing homes were permitted to enlarge their possibilities for allowing visitors in their facility. These nursing homes were proportionally representative of the Netherlands as they were selected by their local Area Health Authority for participation. At each nursing home, a contact person was selected for participation in the current study. Methods: A mixed-methods cross-sectional study was conducted, consisting of questionnaire, telephone interviews, analyses of documentation (ie, local visiting protocols), and a WhatsApp group. Results: Variation in local protocols was observed, for example, related to the use of personal protective equipment, location, and supervision of visits. In general, experiences were very positive. All nursing homes recognized the added value of real and personal contact between residents and their loved ones and indicated a positive impact on well-being. Compliance with local guidelines was sufficient to good. No new COVID-19 infections were reported during this time. Conclusions and Implications: These results indicate the value of family visitation in nursing homes and positive impact of visits. Based on these results, the Dutch government has decided to allow all nursing homes in the Netherlands to cautiously open their homes using the guidelines. More research is needed on impact and long-term compliance.
(Edited publisher abstract)
Objectives: To prevent and control COVID-19 infections, nursing homes across the world have taken very restrictive measures, including a ban for visitors. These restrictive measures have an enormous impact on residents' well-being and pose dilemmas for staff, although primary data are lacking. A Dutch guideline was developed to cautiously open nursing homes for visitors during the COVID-19 pandemic. This study reports the first findings on how the guideline was applied in the local context; the compliance to local protocols; and the impact on well-being of residents, their family caregivers, and staff. Design: A mixed-methods cross-sectional study was conducted. Setting and Participants: In total, 26 nursing homes were permitted to enlarge their possibilities for allowing visitors in their facility. These nursing homes were proportionally representative of the Netherlands as they were selected by their local Area Health Authority for participation. At each nursing home, a contact person was selected for participation in the current study. Methods: A mixed-methods cross-sectional study was conducted, consisting of questionnaire, telephone interviews, analyses of documentation (ie, local visiting protocols), and a WhatsApp group. Results: Variation in local protocols was observed, for example, related to the use of personal protective equipment, location, and supervision of visits. In general, experiences were very positive. All nursing homes recognized the added value of real and personal contact between residents and their loved ones and indicated a positive impact on well-being. Compliance with local guidelines was sufficient to good. No new COVID-19 infections were reported during this time. Conclusions and Implications: These results indicate the value of family visitation in nursing homes and positive impact of visits. Based on these results, the Dutch government has decided to allow all nursing homes in the Netherlands to cautiously open their homes using the guidelines. More research is needed on impact and long-term compliance.
(Edited publisher abstract)
Dementia: the International Journal of Social Research and Practice, 19(2), 2020, pp.488-495.
Publisher:
Sage
The Kintun program is the first public health strategy specifically designed for dementia care in Chile. It was launched in 2013 in the city of Santiago with support from the National Service for the Elderly and the Municipality of Peñalolén. Using an interdisciplinary team, the program seeks to promote community integration and better support for persons with dementia and their caregivers...
(Edited publisher abstract)
The Kintun program is the first public health strategy specifically designed for dementia care in Chile. It was launched in 2013 in the city of Santiago with support from the National Service for the Elderly and the Municipality of Peñalolén. Using an interdisciplinary team, the program seeks to promote community integration and better support for persons with dementia and their caregivers. The multicomponent program includes: an activity-based day care center, training and education of family caregivers, home visits, and community outreach to increase dementia awareness. Case management helps to monitor ongoing needs and link families to resources. To date, 259 dyads (persons with dementia and their families) have been enrolled in the program. Due to its success in 2015, the Kintun program received funding from the Ministry of Health. This has led to the integration of previously disparate initiatives, better consistency across services, and the development of a comprehensive national dementia plan for Chile.
(Edited publisher abstract)
Subject terms:
innovation, intervention, family support, home visiting, dementia, public health, policy, multidisciplinary teams, integration, communities, day centres, day services, training, case management;
Social Science and Medicine, 260, September 2020, p.113150.
Publisher:
Elsevier
...for the English LTC and EOLC policy and planning. The study reveals that hospices provide end-of-life LTC for cancer diagnoses and adults aged 50–64, while care homes provide open-ended and end-of-life LTC for non-cancer diagnoses, dementia, severe disability, and adults aged 80+. Further, the informal, formal, mixed and care home LTCAs reflect increasing levels of disability and ill-health, and decreasing
(Edited publisher abstract)
In the UK and the Westernised countries, most people die aged 80+ from disabling, chronic and degenerative diseases, having spent several years in poor health. There is thus continuity between long-term care (LTC) and end of life care (EOLC) in old age, but this continuity is poorly understood within policy and almost nothing is known about what determines the modality and intensity of LTC provision in old age towards the end of life. Drawing on multinomial logistic regression analysis of the English Longitudinal Study of Ageing (ELSA), this paper evaluates how health and socio-demographic factors affect the relative probability of receiving care through one of five long-term care arrangements (LTCAs) from the time of need at age ≥50 to death; and assesses the consequences this has for the English LTC and EOLC policy and planning. The study reveals that hospices provide end-of-life LTC for cancer diagnoses and adults aged 50–64, while care homes provide open-ended and end-of-life LTC for non-cancer diagnoses, dementia, severe disability, and adults aged 80+. Further, the informal, formal, mixed and care home LTCAs reflect increasing levels of disability and ill-health, and decreasing levels of family support, with differences concerning education and gender. Finally, dementia and Parkinson's disease are the single strongest determinants of high formal LTC provision, and overall high care needs determine high formal LTC provision. Within the English context, the consequences of this are that: 1) Continued reliance on informal family care is not sustainable; 2) To provide free formal LTC to old adults with high care needs is appropriate; and 3) Hospices do not cater for the prevalent form of dying in old age while care homes do, being the de facto hospices for severely disabled, very old (80+) adults with dementia. Yet this is not represented in English EOLC policy and research.
(Edited publisher abstract)
Subject terms:
hospices, care homes, end of life care, dementia, palliative care, policy, adult social care, death, older people, long term care;
Focusing on UK, US, Norway, Australia and South Africa, the report explores the number and experience of carers with people with dementia in different national contexts. It reviews the research evidence and identifies good practice examples from interviews with leading policy makers, care-led organisations, public service leaders, voluntary organisations, businesses and academics. The report...
(Edited publisher abstract)
Focusing on UK, US, Norway, Australia and South Africa, the report explores the number and experience of carers with people with dementia in different national contexts. It reviews the research evidence and identifies good practice examples from interviews with leading policy makers, care-led organisations, public service leaders, voluntary organisations, businesses and academics. The report questions the extent to which different countries are ready for the implications of the demographic changes they face. Textboxes pose questions to government, to employers, to health and social care, and to broader society. The report finds that the number of people living with dementia poses a major challenge across the world and that countries are not ready to face the consequences of demographic changes. It highlights the role everyone has in responding to the rise in dementia and that there is no ’one-size fits all’ approach. It also shows the importance of providing emotional and psychological support to carers and the need to recognise the diversity of carers and caring situations. The report concludes that national governments, health and social services, businesses, families and communities have to find new ways of responding to the rapidly growing number of people with dementia and of supporting the family and friends who care for them.
(Edited publisher abstract)
Subject terms:
carers, dementia, needs, policy, demographics, access to services, good practice, service provision, diversity;
Content type:
research
Location(s):
United Kingdom, United States, South Africa, Australia, Norway