Strengthening home‐based dementia care services in Lithuania – accessibility, assessment, and delivery

Abstract

AbstractBackgroundIncreased diagnostic rates of dementia in Lithuania were an essential factor that led to changes in the legislative framework. At the same time, there is still capacity for change in dementia diagnostic tools, as multiple methods and techniques are currently used. Therefore the development of a single diagnostic process is critical. In addition, family physicians are anticipated to play a more significant part in the diagnostic process due to the increasing number of people living with dementia (PLWD), as family physicians are directly linked to homecare teams.AimsThis study aimed to identify ways homecare teams could deliver customized care and the barriers that impede access to these services. Identifying these subjects could improve understanding of how legislation addresses the accessibility and quality of dementia‐related services for those in need.MethodsRevision of legal acts and related regulations has taken part, which included analysis of the content of services provided at home, amount and length of services, accessibility, and waiting times. Revision of requirements for professionals working in community settings and their postgraduate education programs were scrutinized at a large scale during this study. A home care assessment tool was also included in the research to determine whether people with unrecognized dementia would be entitled to receive care.ResultsIt was revealed that the family physician role is sparse in dementia recognition, and quite frankly, patients with dementia symptoms are sent for psychiatric consultation to confirm the diagnosis. As a result, it leads to a bureaucratic and long‐lasting process, and the start of care is postponed. The study also identified that professionals working at homecare teams do not receive specialized training to address PLWD needs. In addition, nurses are not taught how to recognize primary dementia symptoms and report them. Moreover, legal acts do not oblige healthcare providers to promote and maintain the well‐being of those in need and their caregivers. Emotional well‐being, personal dignity, and control over daily life are also not addressed. Although an assessment tool is structured, people with primary cognitive symptoms would be able to receive home‐based care.