RIGHTTIMEPLACECARE

Improving health services for European citizens with dementia: Development of best practice strategies for the transition from ambulatory to institutional long-term care facilities

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 Obiettivo del progetto (Objective)

'Given the increasing number of patients/consumers with dementia, political action is urgently required to prepare the health care services throughout Europe to deliver cost effective high quality long-term care to people concerned. Currently there is a lack of clinical research data of patients/consumers and informal caregivers to develop best practice strategies for long-term care. RightTimePlaceCare intends to deliver best practice strategies for need-tailored dementia care throughout the dementia care sectors and aims to preserve best available health outcomes for both patients/consumers with dementia and their informal caregivers at affordable cost-benefit ratios. RightTimePlaceCare will describe and analyse the European health, social care and welfare systems, advocacy and informal caregiver support systems for patients/consumers with dementia and intersectorial communication. A European survey will assess the factors influencing the time of admission to institutional long-term nursing care facilities, investigate living conditions and gather clinical data of patients/consumers with dementia and their informal caregivers in long-term formal professional home care and institutional nursing care facilities, and the related economic impact. Consecutively best practice strategies will be developed for intersectorial arrangements needed to improve the effectiveness and efficiency of integrated health care in European dementia care systems, and recommendations for best practice models or interventions in long-term care facilities. RightTimePlaceCare will advance the state of the art in health systems research in dementia care and will improve cooperation between researchers to promote integration and excellence of European dementia care research. The knowledge generated by RightTimePlaceCare will empower the policy and decision makers to manage and reform dementia health care systems in view of common challenges and within the common framework of the EU.'

Introduzione (Teaser)

Europe's ageing populations are witnessing a corresponding rise in the incidence of dementia. Healthcare systems need to provide affordable and high-quality care to meet the long-term needs of people with dementia.

Descrizione progetto (Article)

The EU-funded project http://www.uni-wh.de/en/health/pflegewissenschaft/department-pflegewissenschaft/righttimeplacecare/ (RIGHTTIMEPLACECARE) worked on developing best practice guidelines for such long-term care. Researchers from eight European countries with multidisciplinary expertise joined forces to perform a Europe-wide cross-country comparison study on dementia care.

Clinical research data on formal home care and institutional long-term nursing care were collected through surveys with people with dementia and their informal caregivers, focus group interviews with people with dementia and formal and informal carers, expert panels and literature reviews. Aspects considered included living conditions, nursing care quality, transition to institutionalised care, European social welfare systems and caregiver support systems.

Results revealed considerable variation in nursing skill levels, quality of life, quality of care and burden for informal carers across countries. England, the Netherlands and Sweden had clear-cut guidelines for dementia care while Estonia, Germany and Spain only addressed care for older people in general.

A family-oriented person-centred care approach was found to be the gold standard in the participating European countries. Areas that needed addressing were proactive care planning, caregiver support and interventions as well as palliative care for people with dementia.

Researchers also assessed the economic impact of transition from home care to long-term nursing care. Huge differences in costs, cost estimation and treatment of dementia severity were seen across countries. Enhancing and availing community care services could considerably improve care whilereducing costs. This would also permit some people with dementia to receive home care for a longer period.

RIGHTTIMEPLACECARE activities have highlighted the areas that require improvement for optimal long-term and affordable care of people with dementia in Europe. These findings have led to the formulation of best practices guidelines that will be invaluable to stakeholders involved in policy and decision making. Project outcomes also paved the way for further research on care for people with dementia.