A comparison of four dementia palliative care services using the RE-AIM framework

BMC Geriatrics

Research

Siobhan Fox¹  Suzanne Timmons¹  Aphie Rukundo¹  Niamh O’Connor¹  Aileen Murphy²  W. George Kernohan³  Jonathan Drennan⁴  Suzanne Guerin⁵ 

[1] Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, Cork, Ireland;Department of Economics, University College Cork, Cork, Ireland;Institute of Nursing and Health Research, County Antrim, Ulster University, Shore Road, Newtownabbey, Northern Ireland;School of Nursing and Midwifery, University College Cork, Cork, Ireland;School of Psychology, University College Dublin, Dublin, Ireland;

关键词: Dementia;    Palliative Care;    Community Care;    Community Services;   

DOI  :  10.1186/s12877-023-04343-w

 received in 2023-06-22, accepted in 2023-09-22,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundLiving with a life-limiting illness, people with dementia benefit from palliative care which considers the holistic needs of the person and their family. However, little is known about how palliative care may be best provided to people living with dementia at home in the community. We examined four exemplary dementia palliative care services for people with dementia in the community, to see what activities they were providing, what were the commonalities and differences, and what lessons could be learned.MethodsA long-list of dementia palliative care services in Ireland, Northern Ireland, England, Scotland, and Wales, was identified through a survey, and four exemplar services were chosen based on criteria including: in operation >six months; provides identifiable activities; availability of routinely collected service data; not exclusively for people with dementia in final hours or days of life. Mixed-methods of data collection included interviews, focus-groups and surveys with service staff, surveys of service users, and routinely collected service data. The RE-AIM framework was used to describe and understand the sample of dementia palliative care services.ResultsThe four services had varied organisational structures and were led by different disciplines. However, they all provided common core activities including holistic and person-centred care, early advance care planning with service user involvement, carer support, integrated healthcare services, continuity of care, 24/7 support, bereavement support. All had needs-based referral criteria, accepting any age or dementia sub-type. All supported people with dementia to remain living at home and to have a comfortable, dignified death in their preferred place.ConclusionsAn effective dementia palliative care service may take different forms. Whether the service is dementia-led or Specialist Palliative Care-led, efficacy is associated with providing a range of key activities and implementing them effectively. The data collected strongly suggests the benefits of the dementia palliative care services to a person with dementia and their families and offers valuable insight into the key factors for the establishment and successful running of such services.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023