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Residential and long-term care

Diagnosis, post-diagnostic support

In some strategies, residential and long-term care were addressed distinctly, whereas other strategies addressed these issues as part of other subsections of this report. Issues covered within the strategies ranged from commitments to expand provision of services, definitions around quality and the use of restraints.

Long-term services/specialist units

The Greek strategy set out its intention to establish a network of specialist dementia units (which will be specifically certified), linked to the classification of the person with dementia (received at the point of diagnosis). Scotland briefly refers to ongoing work in this area following a report by a regulatory body, linked to its work on acute hospitals. On a related theme, the Luxembourg strategy proposed defining a formal framework and regulations on the use of restraints in long-term care settings.

The Flemish approach contains an integrated reference framework for the quality of care and life for people living with dementia, with an emphasis in residential care centres on social and person orientated, encouraging interaction between professional caregivers, the person with dementia, their family and friends.

The Israeli strategy contains high-level commitments in relation to long-term institutional services, one of which focused on the needs to develop information and consultation centres, accessible round the clock by telephone to help families access services and to provide responses in crisis situations. Similarly, for people with dementia who require 24-hour care, the Norwegian strategy commits to a programme of new buildings and modernisation of existing buildings which are dementia-friendly and incorporate small departments and housing collectives with space for community living and social activities.

Similarly, the Swiss strategy contains a broad commitment to promoting long-term in-patient nursing and care for people with dementia through the adaptation of existing infrastructure and care processes.

A slightly different approach was that of the Northern Irish strategy which framed the issue in terms of pathways, to ensure that health trusts were able to responds to crisis situations (involving people with dementia), including in relation to intermediate care.

Residential homes/nursing homes

The English strategy contains a broad commitment that all hospitals and care homes should meet agreed criteria to become dementia friendly.

Both the Irish and Flemish strategies contain commitments in relation to the use of restraints in care homes, with the former implementing a national policy on the use of restraints and the latter requesting input from a bioethics advisory committee about the application of measures that restrict the liberty of people with dementia in residential care settings.

In relation to nursing homes, the Maltese strategy proposed to introduce recommendations and quality measures to enhance patient-centred dementia management and care (including dementia-friendly design) in long-term nursing and residential care settings, in both public and private settings. These included ensuring buildings were dementia friendly in design, including secured open areas and development of meaningful activities for residents.

The Irish strategy committed to examining a range of long-term care options including new residential models, such as including housing with care, for people with dementia. Similarly, the Maltese strategy commits to developing new long-term housing units for individuals with dementia.

The Norwegian strategy commits to the development of a quality tool for all nursing homes, setting out criteria for good practice focused on management, organisation, professional practice, innovation and patient outcomes. Additionally, the Northern Irish strategy proposes developing standards in this area which will cover quality care, use of medications, links with community settings etc. which will also be included within the service specification to inform the commissioning of dementia services.

The Scottish strategy commits to specific work in this area, continuing the National Group on Dementia in Care Homes (established under the previous strategy) to ensure the ongoing modernisation of care homes takes account of the needs of people with dementia, including through the consideration of themed inspections by the national regulator.

Other

The German strategic document focuses on its social health insurance system, specifically on revising criteria and procedures for rehabilitation needs for people with dementia. In addition, the Federal Government will develop and launch a long-term care fund to create demographic reserves.

It was again notable within this section that the Flanders strategy contained specific consideration of people with younger-onset dementia and whether dedicated workers for this group may be of value.

The Northern Irish strategy commits to working with a number of national partners and to developing environmental standards for all new facilities providing care solely or mainly for people with dementia, as well as assessing existing facilities used by people with dementia.

 

 
 

Last Updated: Monday 29 April 2019

 

 
  • Acknowledgements

    This report received funding under an operating grant from the European Union’s Health Programme (2014-2020). The content of the Yearbook represents the views of the author only and is his/her sole responsibility; it cannot be considered to reflect the views of the European Commission and/or the Consumers, Health, Agriculture and Food Executive Agency or any other body of the European Union. The European Commission and the Agency do not accept any responsibility for use that may be made of the information it contains
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