229133 Examining the challenges of implementing different dementia care models in Scotland

Monday, November 8, 2010

Michael Ramsay, MSc, RMN , School of Nursing & Midwifery, University of Dundee, Dundee, United Kingdom
Catherine Spence, BSc (Hons), RMN , School of Nursing & Midwifery, University of Dundee, Dundee, United Kingdom
Bijay Previn, BSc, RMN , Mental Health Nursing, Murray Royal Hospital, Perth, United Kingdom
Walter Cambers, BA, RMN , Mental Health, Queen Margaret Hospital, Dunfermline, United Kingdom
Thilo Kroll, PhD , School of Nursing & Midwifery / Alliance for Self-Care Research, University of Dundee, Dundee, United Kingdom
Background: Dramatic projected increases in the incidence and prevalence of dementia has prompted health and social care systems to respond. The delivery of dementia care in the community has spawned a variety of care and service delivery models.

Aim: The aim of this study is to examine the history and differences in the implementation of dementia service models in Scotland, compare these models across urban, mixed rural/urban and remote rural contexts and to examine to what extent these models are evidence-based.

Methods: The study used a multi-method approach combining a structured literature review with a case-study based in-depth interview approach. The literature review explored the evidence base for community-based dementia care service models involving multiple scientific literature databases (MEDLINE, CINAHL, EMBASE, PSYCINFO) and grey literature through Google TM. Three different community-based dementia service models in Fife, Angus and Perth and Kinross were explored using observational and interview-based methods. The sample included, 10 people with early onset dementia,10 non-professional carers and 10 health professionals (community nurses, general practitioners, psychologists).

Results: Service model evaluations continues to be sparse. Available evidence favours multi-disciplinary community-based approaches and mulit-agency coordination. The literature review highlighted that individual level focus needs to be replaced by a systemic and prospective perspective. Multi-agency goals fall particularly short in remote and rural areas. Individual interviews showed that the use of evidence-based models in providing care is still limited.

Conclusion: Emergent legislation and policy is responding to the changing epidemiology of dementia, therefore evidence-based support for interventions is urgently needed.

Learning Areas:
Implementation of health education strategies, interventions and programs
Public health or related nursing

Learning Objectives:
1. Identify a basis for a systematic evaluation of community-based dementia care services in Scotland 2. Identify the potential for extending the role of community nursing in dementia service delivery 3. Highlight gaps in the evidence-base that underpins current dementia service provision in the community

Keywords: Community Health Programs, Dementia

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Researcher and co-applicant on the project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.