Health Policy

“We don’t have the infrastructure to support them at home”: How health system inadequacies impact on long-term care admissions of people with dementia.

Donnelly, N.A., Humphries, N., Hickey, A. and Doyle, F.
Health Policy
2017
This qualitative study examined the role of Irish healthcare system factors on the admission of people with dementia to long term care. Community care services were evidenced to be under resourced and inequitable.
Examples included a lack of continuity of care in the community and considerable differences in access to services based on geographical location. The constraint in community services creates a situation where in the absence of adequate support, even for a short term crisis, families are forced to consider admitting their loved one to hospital. A further complicating factor is that in the face of lengthy waiting lists for community services, health and social care professionals will sometimes advsie a family to admit the person with dementia to hospital as a way to speed up access to services. When someone is admitted to acute care, this is seen to accelerate admission to long term care with people with dementia reprorted to often deteriorate during their stay. It is also often at this point that health care professionals take the lead in decision making and control moves away from the family. Irish government policy advocates supporitng people to live well in their own homes for as long as possible but the authors suggest current indaequacies in the system, that were exacerbated by the economic crisis, have resulted in community services that fail to meet policy objectives.
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