Developing services for people with dementia

Abstract

Health and social care agencies located in rural areas face particular challenges if they are to be able to effectively support people with dementia within their communities. Ann McDonald and Becky Heath describe a piece of work carried out in three rural counties in East Anglia that mapped services across the statutory, voluntary and private sectors and explored how national policy was being interpreted to meet local need. The findings confirm that services for older people with dementia are under-developed compared to those for older people generally, but reveal that there is the potential to develop community-based and inclusive services for people who have dementia.

Dementia-Related Education and Support Service Availability, Accessibility, and Use in Rural Areas: Barriers and Solutions

“…Similarly, Alzheimer Society staff reported fewer services provided by other organizations (e.g., day programs) in rural compared to urban locations (Herron et al, 2016). Particular gaps in services were reported for people with young onset dementia and those belonging to an ethnic or sexual minority group (McDonald & Heath, 2009;Moore, 2002). Finally, limited choices in type, amount, and provider were identified even when services were available (Forbes et al, 2011;Forbes et al, 2013;Innes, Sherlock, & Cox, 2003;Kelsey & Laditka, 2006;Mason et al, 2005;O'Reilly & Strong, 1997).…”

“…Collaboration between organizations and sectors was suggested as a feature of high-quality service provision and a way to enhance service accessibility (Clancy, 2015;Forbes et al, 2012;Innes et al, 2006;Mason et al, 2005;McDonald & Heath, 2009;O'Reilly & Strong, 1997). Service providers in Innes et al's (2006) research reported that effective partnerships with other agencies allowed them to share knowledge, funding, and transportation schemes, strengthening the accessibility and quality of services (see also Mason et al, 2005).…”

“…For example, after realizing the importance of spirituality to their elderly Japanese service users, Nomura et al (2009) adapted their cognitive rehabilitation intervention to include temples and shrines as settings for the recall of autobiographical memories. Person-centred services were identified as a priority by participants in McDonald and Heath's (2009) research, and a personcentred perspective was implemented in day programs by learning the past hobbies, interests, and current preferences of users, changing programming to match interests and desires, providing meaningful activities, creating comfortable settings, and regularly evaluating activities from users' perspectives (Kelsey & Laditka, 2006).…”

From Beginning to End: Perspectives of the Dementia Journey in Northern Ontario

“…A search of the literature revealed that the investigation into the dementia experience in rural northern communities has been largely untouched, with the exception of a few pockets of research occurring in Canada and elsewhere (Edelman, Kuhn, Fulton, & Kyrouac, 2006; Morgan et al, 2002). McDonald and Heath (2008) examined the provision of health and social services for people with dementia in three rural communities in the United Kingdom and found an underdevelopment of dementia care services and policies. Interestingly, the authors pointed out that carers were also quite aware of the “rationing” of services and, although discouraged by the limited availability of professional supports, had an expectation and sense of entitlement to support from within the community that was fulfilled by family, volunteers, and other community members (McDonald & Heath).…”

Availability and Primary Health Care Orientation of Dementia-Related Services in Rural Saskatchewan, Canada

“…In Canada, rural family caregivers reported fewer service options for community-based dementia services than those in urban settings (Forbes et al, 2008) . A study of service provision in rural England (McDonald & Heath, 2009) identified gaps including patchy service provision, absence of training opportunities, and difficulties recruiting staff.…”