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Implementing post-diagnostic support for people living with dementia in England and Wales: A qualitative study of barriers and strategies used to address these in practice

Lookup NU author(s): Dr Alison Wheatley, Claire Bamford, Dr Greta Brunskill, Dr Laura Booi

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).


Abstract

Background Inequalities and gaps in post-diagnostic support (PDS) for people with dementia persist despite a policy focus on dementia in England and Wales. Understanding and overcoming the factors contributing to these inequalities is vital to improve care for people living with dementia and their families. Objective to explore common barriers to the delivery of PDS in England and Wales and describe successful strategies to address them, drawing on examples from current practice. Design qualitative semi-structured interviews, focus groups, and observation. Setting Phase 1: interviewees were drawn from multiple sectors across England and Wales, including NHS clinical commissioning groups and social care. Phase 2: six case study sites based in different sectors (primary care, secondary mental health, third sector) in England. Participants Phase 1: 61 professionals, including commissioners and service managers. Phase 2: 68 professionals, including frontline staff and those working in related services; 17 people living with dementia; 31 carers. Results Barriers to implementing PDS in dementia were an unsupportive infrastructure, limited proactive review and limited capacity and capability particularly in primary care. Strategies used successfully in practice to address these challenges included creating opportunities for service development, improving joint working, supporting non-specialists and developing ongoing, holistic review and care planning. Conclusions A range of practical strategies have been identified to address many of the common barriers to PDS in dementia. To achieve policy goals of a task-shifted and task-shared approach to PDS, widespread use of these strategies is recommended.


Publication metadata

Author(s): Wheatley A, Bamford C, Brunskill G, Booi L, Harrison Dening K, Robinson AL

Publication type: Article

Publication status: Published

Journal: Age and Ageing

Year: 2021

Pages: epub ahead of print

Online publication date: 06/07/2021

Acceptance date: 20/04/2021

Date deposited: 20/04/2021

ISSN (print): 0002-0729

ISSN (electronic): 1468-2834

Publisher: Oxford University Press

URL: https://doi.org/10.1093/ageing/afab114

DOI: 10.1093/ageing/afab114


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