Login Register Cart 0
Generic placeholder image

Current Alzheimer Research

Editor-in-Chief

ISSN (Print): 1567-2050
ISSN (Online): 1875-5828

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe Translate in Chinese
Research Article

Understanding the Obstacles to Uptake of Intervention Programmes and Services for Persons with Dementia

Author(s): Ha N.H. Lien, Emily J. Koh and Philip L.K. Yap*

Volume 17, Issue 6, 2020

Page: [526 - 533] Pages: 8

DOI: 10.2174/1567205017666200807192634

Price: $65

Abstract

Background: Utilisation of intervention programmes and services for Persons with Dementia (PWD) has been generally modest despite the growing numbers. One reason has been the lack of knowledge about dementia and information on such services.

Objective: We sought to close this gap by providing caregivers with an information session about dementia and the importance and availability of related services. We explored the uptake of intervention programmes and services and reasons for non-uptake thereafter.

Methods: Two hundred and seventy-five PWD and caregiver dyads attended the Dyad Education and Empowerment Programme (DEEP). At the DEEP, while caregivers underwent an information session, PWD were assessed by a multidisciplinary team on their need and suitability for programmes and services such as daycare, cognitive engagement programmes and physical rehabilitation. The dyads then received individualized recommendations on the appropriate services, if any. Follow-up through medical records review and phone calls was conducted one month after DEEP to ascertain if the dyads had acted upon the recommendations and if not, what difficulties they encountered.

Results: One hundred and eleven PWD received recommendations, of which 40 (36.0%) agreed and enrolled in the services while 71 (64%) declined. Thematic analysis of the reasons for non-uptake revealed 3 themes: PWD-related factors (e.g., refusal, functional improvement or decline), caregiverrelated factors (adequacy of care at home, other care arrangements), and service-related factors (e.g., cost, timing).

Conclusion: Despite adequate information, there are other reasons for non-uptake of dementia- related services, some of which should be addressed to improve service updates and to provide better care for PWD.

Keywords: Persons with dementia, intervention programmes and services, service non-uptake, homecare, integrated care, dementia- friendly community.

« Previous Next »
[1]
American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5 5th ed, ed DSMTF American Psychiatric Association. Washington, DC: American Psychiatric Publishing . 2013.
[2]
World Health Organisation. Towards a Dementia Plan: A WHO Guide. Internet 2018.
[3]
Subramaniam M, Chong SA, Vaingankar JA, et al. Prevalence of dementia in people aged 60 years and above: Results from the WiSE Study. J Alzheimer Dis 2015; 45(4): 1127-38.
[http://dx.doi.org/10.3233/JAD-142769] [PMID: 25672767]
[4]
Woo LL, Thompson CL, Magadi H. Monetary cost of family caregiving for people with dementia in Singapore. Arch Gerontol Geriatr 2017; 71: 59-65.
[http://dx.doi.org/10.1016/j.archger.2017.03.006] [PMID: 28347930]
[5]
Poblador-Plou B, Calderón-Larrañaga A, Marta-Moreno J, et al. Comorbidity of dementia: A cross-sectional study of primary care older patients. BMC Psychiatry 2014; 14(1): 84-4.
[http://dx.doi.org/10.1186/1471-244X-14-84] [PMID: 24645776]
[6]
Chiou CJ, Chang HY, Chen IP, Wang HH. Social support and caregiving circumstances as predictors of caregiver burden in Taiwan. Arch Gerontol Geriatr 2009; 48(3): 419-24.
[http://dx.doi.org/10.1016/j.archger.2008.04.001] [PMID: 18602706]
[7]
Chang H-Y, Chiou C-J, Chen N-S. Impact of mental health and caregiver burden on family caregivers’ physical health. Arch Gerontol Geriatr 2010; 50(3): 267-71.
[http://dx.doi.org/10.1016/j.archger.2009.04.006] [PMID: 19443058]
[8]
Tam WJ, Koh GC, Legido-Quigley H, Ha NHL, Yap PLK. “I can’t do this alone”: A study on foreign domestic workers providing long-term care for frail seniors at home. Int Psychogeriatr 2018; 30(9): 1269-77.
[http://dx.doi.org/10.1017/S1041610217002459] [PMID: 29151397]
[9]
Lyketsos CG, Christopher CC, Blank KP, et al. Position statement of the american association for geriatric psychiatry regarding principles of care for patients with dementia resulting from Alzheimer disease. Am J Geriatr Psychiatry 2006; 14(7): 561-72.
[http://dx.doi.org/10.1097/01.JGP.0000221334.65330.55] [PMID: 16816009]
[10]
Nagaendran K, Chen LHC, Chong MS, et al. Ministry of health clinical practice guidelines: Dementia. Singapore Med J 2013; 54(5): 293-8.
[http://dx.doi.org/10.11622/smedj.2013112] [PMID: 23716158]
[11]
Cohen-Mansfield J. Nonpharmacologic interventions for inappropriate behaviors in dementia: A review, summary, and critique. Am J Geriatr Psychiatry 2001; 9(4): 361-81.
[http://dx.doi.org/10.1097/00019442-200111000-00005] [PMID: 11739063]
[12]
Ministry of Health. Intermediate and Long-term Care (ILTC) Services. Available from: . https://www.moh.gov.sg/our healthcare system/healthcare services and facilities/intermediate and long term care (iltc) services
[13]
Huang S, Grive K, Bryant CA, et al. Non-use of day care services for dementia in Singapore - a dilemma for caregivers. Int Psychogeriatr 2016; 29(3): 1-12.
[14]
Lim J, Goh J, Chionh HL, Yap P. Why do patients and their families not use services for dementia? Perspectives from a developed Asian country. Int Psychogeriatr 2012; 24: 1571-80.
[http://dx.doi.org/10.1017/S1041610212000919]
[15]
Gill CE, Hinrichsen GA, DiGiuseppe R. Factors associated with formal service use by family members of patients with dementia. J Appl Gerontol 1998; 17(1): 38-52.
[http://dx.doi.org/10.1177/073346489801700103]
[16]
Cations M, Withall A, Horsfall R, et al. Why aren’t people with young onset dementia and their supporters using formal services? Results from the INSPIRED study. PLoS One 2017; 12(7) e0180935
[http://dx.doi.org/10.1371/journal.pone.0180935] [PMID: 28723931]
[17]
Beeber A, Thorpe J, Clipp EC. Community-based service use by elders with dementia and their caregivers: A latent class analysis. Nurs Res 2008; 57(5): 312-21.
[http://dx.doi.org/10.1097/01.NNR.0000313500.07475.eb PMID:18794715]
[18]
Wee S-L, Hu AJ, Yong J, Chong WF, Raman P, Chan A. Singaporeans’ Perceptions of and Attitudes Toward Long-Term Care Services. Singaporeans’ perceptions of and attitudes toward long-term care services. Qual Health Res 2015; 25(2): 218-27.
[http://dx.doi.org/10.1177/1049732314549812] [PMID: 25201582]
[19]
Phillipson L, Jones SC, Magee C. A review of the factors associated with the non-use of respite services by carers of people with dementia: Implications for policy and practice. Health Soc Care Community 2014; 22(1): 1-12.
[http://dx.doi.org/10.1111/hsc.12036] [PMID: 23530738]
[20]
Durand M, James A, Ravishankar A, Bamrah JS, Purandare NB, Purandare NB. Domiciliary and day care services: Why do people with dementia refuse? Aging Ment Health 2009; 13(3): 414-9.
[http://dx.doi.org/10.1080/13607860902879318] [PMID: 19484605]
[21]
Stephan A, Bieber A, Hopper L, et al. Actifcare Consortium. 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(1): 131-6.
[http://dx.doi.org/10.1186/s12877-018-0816-1] [PMID: 29866102]
[22]
Goh NS. Post acute care of the elderly in singapore: What factors influence use of services. Asia Pac J Soc Work Dev 2011; 21: 31-53.
[http://dx.doi.org/10.1080/21650993.2011.9756095]
[23]
Brodaty H, Thomson C, Thompson C, Fine M. Why caregivers of people with dementia and memory loss don’t use services. Int J Geriatr Psychiatry 2005; 20(6): 537-46.
[http://dx.doi.org/10.1002/gps.1322] [PMID: 15920707]
[24]
Peel E, Harding R. ‘It’s a huge maze, the system, it’s a terrible maze’: Dementia carers’ constructions of navigating health and social care services. Dementia 2014; 13(5): 642-61.
[http://dx.doi.org/10.1177/1471301213480514] [PMID: 24339077]
[25]
Cotrell V, Engel RJ. The role of secondary supports in mediating formal services to dementia caregivers. J Gerontol Soc Work 1999; 30(3-4): 117-32.
[http://dx.doi.org/10.1300/J083v30n03_10]
[26]
Montoro Rodriguez J, Kosloski K, Montgomery R. Evaluating a practice-oriented service model to increase the use of respite services among minorities and rural caregivers. Gerontologist 2003; 43: 916-24.
[27]
Setia M, Islam AM, Thompson JP, Matchar DB. Stakeholders’ perspective on issues and challenges associated with care and treatment of aging-related cognitive impairment disorders in Singapore. Int Psychogeriatr 2011; 23(9): 1421-32.
[http://dx.doi.org/10.1017/S1041610211000846] [PMID: 21682939]
[28]
Vaingankar J, Subramaniam M, Picco L, et al. Perceived unmet needs of informal caregivers of people with dementia in Singapore. Int Psychogeriatr 2013; 25(10): 1-15.
[http://dx.doi.org/10.1017/S1041610213001051]
[29]
Tan QLL, Chye LMY, Ng DHM, Chong MS, Ng TP, Wee SL. Feasibility of a community-based Functional Power Training program for older adults. Clin Interv Aging 2018; 13(13): 309-16.
[http://dx.doi.org/10.2147/CIA.S157911] [PMID: 29503535]
[30]
DiZazzo-Miller R, Pociask F, Samuel P. Understanding resource needs of persons with dementia and their caregivers. Michigan Fam Rev 2013; 17(1): 1.
[http://dx.doi.org/10.3998/mfr.4919087.0017.102]
[31]
Hansen A, Hauge S, Bergland Å. Meeting psychosocial needs for persons with dementia in home care services - a qualitative study of different perceptions and practices among health care providers. BMC Geriatr 2017; 17(1): 211-10.
[http://dx.doi.org/10.1186/s12877-017-0612-3] [PMID: 28893181]
[32]
Low L-F, Fletcher J. Models of home care services for persons with dementia: A narrative review. Int Psychogeriatr 2015; 27(10): 1593-600.
[http://dx.doi.org/10.1017/S1041610215000137] [PMID: 25672570]
[33]
Moholt J-M, Friborg O, Blix BH, Henriksen N. Factors affecting the use of home-based services and out-of-home respite care services: A survey of family caregivers for older persons with dementia in Northern Norway. Dementia 2020; 19(5): 1712-31.
[http://dx.doi.org/10.1177/1471301218804981] [PMID: 30322275]
[34]
Nurjono M, Yoong J, Yap P, Wee SL, Vrijhoef HJM. Implementation of integrated care in singapore: A complex adaptive system perspective. Int J Integr Care 2018; 18(4): 4.
[http://dx.doi.org/10.5334/ijic.4174] [PMID: 30483037]
[35]
Heward M, Innes A, Cutler C, Hambidge S. Dementia-friendly communities: Challenges and strategies for achieving stakeholder involvement. Health Soc Care Community 2017; 25(3): 858-67.
[http://dx.doi.org/10.1111/hsc.12371] [PMID: 27406118]
[36]
Phillipson L, Cridland E, Fleming R, et al. Involvement of people with dementia in raising awareness and changing attitudes in a dementia friendly community pilot project. Dementia 2019; 18(7-8): 2679-94.
[PMID: 29363336]
[37]
Handley M, Bunn F, Goodman C. Dementia-friendly interventions to improve the care of people living with dementia admitted to hospitals: A realist review. BMJ Open 2017; 7(7) e015257
[http://dx.doi.org/10.1136/bmjopen-2016-015257] [PMID: 28713073]

Rights & Permissions Print Cite
Article Metrics
18
1
© 2024 Bentham Science Publishers | Privacy Policy