gms | German Medical Science

Background and Purpose: Access to community services is often gained late in the trajectory of dementia, albeit particularly helpful.

Model/Framework: The Behavioral Model of Health Services Use guided the overall project.

Methods: Focus groups and semi-structured expert interviews.

Research Focus: Within the Actifcare project in eight European countries, 55 focus groups with 266 participants were conducted with people with dementia, carers and professionals to investigate how barriers and facilitators to using formal community care are experienced. Consecutively, strategies improving service use were explored by 38 expert interviews with political decision makers/influencers. A summarising qualitative content analysis was performed in each country and national reports were synthesised.

Methodological and Theoretical Focus: A qualitative approach was used, addressing challenges of collection and analysis of qualitative data in different languages.

Results: Using formal community care seems to be influenced by psychosocial factors, characteristics of professionals and system-related aspects. Findings highlight the impact of beliefs of people with dementia and carers (e.g. meaning of caregiving), and underline that people with dementia try to stay independent as long as possible, while using formal care is often considered as a threat to independence. Political decision-makers/influencers identified strategies of dementia care that reflect these barriers and facilitators (e.g. care coordinator, proactive person-centred services, public awareness). Nevertheless, implementation of these strategies remains a challenge.

Conclusions: Further research needs to investigate how good-practice strategies can be appropriately implemented, and how formal care can be modified towards supporting the independence of people with dementia and better address psychosocial factors.