Home care services for people with dementia - Tailored and person-centered for improved quality of care

Abstract

Nearly half of all people over the age of 70 who receive home care services in Norway have dementia. People with dementia may have complex needs, and a person-centered and holistic approach is recommended. Given the facts that the number of elderly people is increasing and that more people with dementia are being cared for in their own homes, understanding the ways in which home care services can provide high-quality tailored care is important. TIME is a holistic approach for staff for the assessment and treatment of neuropsychiatric symptoms in dementia. This is a structured approach that involves a holistic understanding of the patient’s behavior when the patient’s perspective, social factors, dignity and integrity serve as a foundation for tailored interventions. The aim of the thesis was to add knowledge concerning home care services for people with dementia and to identify relevant opportunities and challenges associated with the use of the TIME model to facilitate tailored care and support for people with dementia. The thesis consists of three published research articles that reference empirical data regarding home care services in Norway, using both qualitative and quantitative data. Our findings indicate that a traditional way of organizing home care services can complicate person-centered care. The complexity of both the home care service and patients with dementia causes the task of tailoring the service to the individual patient to be challenging. People with dementia desire to live in their own homes and the ways people adapts to the service without requesting changes based on their wishes or needs highlight the service’s responsibility to provide tailored care to the individual patient. The staff experienced TIME as a systematic way of working and was perceived to be useful when combined with a comprehensive assessment of the patient and subsequent reflection on tailored measures to provide person-centered care to people with dementia.