Background
Aims
Methods
Design
Context
National regulations | National guidelines | Insurances | |
---|---|---|---|
Estonia | Welfare services for the elderly | No national guidelines | Estonian Health Insurance Fund |
Finland | The social and health care system | Under development | National Health Insurance |
France | Long-term care | The Alzheimer’s disease plan “Plan AD 2008–2012” | National Health Insurance |
Germany | Health care and long-term care | Three guidelines from different medical scientific societies | Long-Term Care Insurance |
The Netherlands | Within the Health Insurance Act and the Social Support Act | “National Dementia Program” | Exceptional Medical Expenses Act (AWBZ): informal caregivers can apply for needs assessment |
Spain | Universal Health Coverage | No national guidelines | Cohesion Fund |
Law 39/2006: promotion of personal autonomy and care of people with dependency | |||
Sweden | Within the Social Services Act and the Health and Medical Service Act | National guidelines for care and service for dementia | National Health Insurance |
England | Within the Community Care Act and the National Health Service Act | The National Dementia Strategy for England | The National Health Service (NHS) |
The sample
The instrument
ISCED LEVEL: At or above ISCED level | General health care training | Specialized health care training | Specialized training in dementia |
---|---|---|---|
7: Master’s or equivalent, vocational | Psychologist (psychol), provides counseling and help to people with psychological problems | GP, physician who treats patients within a district for all types of diseases | MD geriatrics (MD-ger), geriatrician or psycho-geriatrician specialized in geriatrics |
MD psychiatry1 (MD-psych)/Old Age Psychiatrist, specialized in psychiatry | |||
Social worker (SW), provides staff management for residential care or home help service | MD neurology1 (MD-neuro), specialized in neurology | ||
MD-internal medicine, specialized in internal medicine | |||
Physiotherapist, provides rehabilitation to identify and improve, e.g., disabled movement and function | |||
6: Bachelor’s or equivalent, vocational | Social worker, provides staff management for residential care or home help service | Community psychiatric registered nurse, (RN-comm-psych), supports older people at home and in nursing/residential homes. Specialized in psychiatry. | RN specialized in dementia (RN dem), has an overall responsibility for dementia care in an area/municipality. Provides counseling, supervision, and assessments, and mediates contacts. Education at advanced level: Care of the elderly (1 year Master), District nurse (1 year Master), Psychiatric care (1 year Master). |
Home help officer, carries out needs assessment prior to decision about home services and care | |||
Registered nurse (RN), provides care and service including help with PADLs, medical treatments, and managing the nursing care team | |||
Case manager, professional (nurse or social worker) function that may include finding and outreach, comprehensive assessment and care planning, coordination of service, service provision, monitoring, and evaluation, and, in addition, meeting special needs | |||
Occupational therapist (OT), provides rehabilitation to achieve optimum level of functional ability. This may include adaptation of the home and providing aids and equipment to assist with managing everyday activities. | |||
Physiotherapist2, provides rehabilitation to identify and improve, e.g., disabled movement and function. | |||
Case manager, see “Specialized health care training” | |||
5: Short-cycle tertiary education, vocational | Registered nurses, not Bachelor’s level | State examined nurses specialized in dementia care | |
(SEN dem), not Bachelor’s level | |||
State examined nurse (SEN), not Bachelor’s level | |||
Occupational therapist, Bachelor’s level, provides rehabilitation to achieve optimum level of functional ability. This may include adaptation of the home and providing aids and equipment to assist in managing everyday activities. | |||
4: Post-secondary non-tertiary, vocational | Licensed practical nurse (LPN)/auxiliary nurse (Aux-N), provides care and service including help with IADLs and PADLs, and, in addition, minor medical treatment. Health care trained at secondary school level. | ||
3: Upper secondary, vocational | Nurse aid/assistant nurse (Ass-N), provides care and service including help with IADLs and PADLs. Health care trained for <6 months (OECD 2005). | ||
Support worker (Supp-work), home carer, psychological supporter, or home trainer paid at enhanced nursing assistant/home carer rate. Social care/nursing trained at secondary level or trained on the job. | |||
<3 | Social worker assistant (SW-ass), performs some similar tasks as the social worker. Not trained, or trained on the job |
Diagnosis stage | Early stage: mild cognitive impairment | Intermediate stage: moderate cognitive impairment | Late stage: severe cognitive impairment | End of life stage | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Available for | Utilized by | Available for | Utilized by | Available for | Utilized by | Available for | Utilized by | Available for | Utilized by | ||
Counseling: Informal and formal, professionals or agency providing support to persons with dementia (PwDs) and their family. | EE | No one | No one | No one | No one | No one | No one | No one | No one | No one | No one |
FI | All | Most | All | Most | All | Most | All | Most | All | Most | |
FR | Most | Most | Most | Most | Most | Most | Few | Few | No one | No one | |
DE | Most | Few | Most | Few | Most | Few | Most | Few | Most | Few | |
NL | All | Most | All | Most | All | Most | All | Most | All | Most | |
ES | All | Most | All | Most | All | Most | All | Most | All | Most | |
SE | All | Few | All | Most | All | Most | All | Most | Few | Most | |
E | Few | Few | Few | Few | Few | Few | Few | Few | Few | Few | |
Caregiver support: Organization where professionals provide support, such as counseling, individually and/or in groups, and provide home visits to informal caregivers. | EE | Few | Few | Few | Few | Few | Few | Few | Few | Few | Few |
FI | All | Few | All | Few | All | Most | All | Most | All | All | |
FR | Few | Few | Few | Few | Few | Few | Few | Few | Few | Few | |
DE | Most | Few | Most | Few | Most | Few | Most | Few | Most | Few | |
NL | All | Most | All | Most | All | Most | All | Most | All | Most | |
ES | Most | Most | Most | Most | Most | Most | Most | Most | Most | Most | |
SE | All | Few | All | Few | All | Few | All | Few | All | Few | |
E | Most | Few | Most | Few | Most | Few | Most | Few | Most | Few | |
Caregiver education: Training for informal caregivers providing care and service to PwDs. Education includes needs and symptoms of dementia. | EE | Most | Few | Most | Few | Most | Few | Most | Few | Most | Few |
FI | All | Few | All | Few | All | Few | All | Few | All | Few | |
FR | Most | Few | Most | Few | Most | Few | Most | Few | Most | Few | |
DE | All | Few | All | Few | All | Few | All | Few | All | Few | |
NL | All | Most | All | Most | All | Most | All | Most | All | Most | |
ES | Few | Few | Few | Few | Few | Few | Few | Few | Few | Few | |
SE | Most | Few | Most | Few | Most | Few | Most | Few | Most | Few | |
E | Most | Few | Most | Few | Most | Few | Most | Few | Most | Few | |
Informal caregivers – reimbursed: Informal caregivers employed by the public to provide care and service. | EE | No one | No one | No one | No one | No one | No one | No one | No one | No one | No one |
FI | No one | No one | No one | No one | Most | Most | Most | Most | All | All | |
FR | Few | Few | Few | Few | Few | Few | Most | Most | Few | Few | |
DE | Most | Most | Most | Most | Most | Most | Most | Most | Most | Most | |
NL | All | Few | All | Few | All | Few | All | Few | All | Few | |
ES | No one | No one | No one | No one | Most | Most | All | Most | All | Most | |
SE | Few | No one | Few | Few | Few | Few | Few | Few | Few | Few | |
E | All | Few | All | Few | All | Few | All | Few | All | Few | |
Informal caregivers – not reimbursed: Informal caregivers provide care and service voluntarily. | EE | Most | Most | Most | Most | Most | Most | Most | Most | Most | Most |
FI | Most | Most | Most | Most | Most | Most | Most | Most | Most | Most | |
FR | Most | Most | Most | Most | Most | Most | Most | Most | Few | Few | |
DE | Few | Few | Few | Few | Few | Few | Few | Few | Few | Few | |
NL | All | Most | All | Most | All | Most | All | Most | All | Most | |
ES | All | All | All | All | All | All | All | All | All | All | |
SE | All | Most | All | Most | All | Most | All | Most | All | Most | |
E | All | Most | All | Most | All | Most | All | Most | All | Most | |
Day care/day activity/day care center/day hospital: Clinic or agency providing social activities and activities to stimulate physical, mental, and intellectual functional ability, daytime. | EE | Most | Few | Most | Few | Most | Few | Few | Few | No one | No one |
FI | Few | Most | Few | Most | Few | Most | No one | No one | No one | No one | |
FR | Most | Most | Most | Most | Most | Most | Few | Few | No one | No one | |
DE | Few | No one | Few | Few | Few | Few | Few | Few | Few | No one | |
NL | All | All | All | All | All | All | All | All | All | All | |
ES | No one | No one | Most | Few | Most | Few | No one | No one | No one | No one | |
SE | Most | Few | Most | Few | Most | Few | Most | Few | No one | No one | |
E | Most | Few | Most | Few | Most | Few | Most | Few | Few | Few | |
Day care/day activity/day care center/day hospital specialized in dementia care: Clinic or agency with staff specialized in dementia care providing social activities and activities to stimulate cognitive ability, daytime. Only persons with dementia are admitted. | EE | Few | Few | Few | Few | Few | Few | Few | Few | No one | No one |
FI | Few | Most | Most | Most | Most | Most | Most | Most | No one | No one | |
FR | Most | Most | Most | Most | Most | Most | Most | Most | Most | Most | |
DE | Few | No one | Few | Few | Few | Few | Few | Few | Few | No one | |
NL | All | All | All | All | All | All | All | All | All | All | |
ES | No one | No one | Few | Few | Few | Few | Few | Few | No one | No one | |
SE | Few | Few | Few | Few | Few | Few | For few | Few | No one | No one | |
E | Most | Few | Most | Few | Most | Few | Most | Few | Most | Few | |
Respite care at home: Care at home to provide relief to informal caregivers who are caring for a family member/close friend. | EE | Few | Few | Few | Few | Few | Few | Few | Few | Few | Few |
FI | All | Few | All | Few | All | Few | All | Most | All | Most | |
FR | No one | No one | No one | No one | No one | No one | No one | No one | No one | No one | |
DE | All | No one | All | Few | All | Few | All | Few | All | Few | |
NL | All | All | All | All | All | All | All | All | All | All | |
ES | No one | No one | No one | No one | No one | No one | No one | No one | No one | No one | |
SE | All | Few | All | Few | All | Few | All | Few | All | Few | |
E | Most | Few | Most | Few | Most | Few | Most | Few | Most | Few |
ISCED level 7: Master’s or equivalent, vocational | ISCED level 6: Bachelor’s or equivalent, vocational | ISCED level 5: Short-cycle tertiary education, vocational | ISCED level 4: Post-secondary non-tertiary, vocational | ISCED level 3: Upper secondary, vocational | ||
---|---|---|---|---|---|---|
Counseling: Informal and formal, professionals or agencies providing support to persons with dementia (PwDs) and their family. | EE | |||||
FI | RN, RN dem | Aux-N | ||||
FR | Psychologist | |||||
DE | Case manager2 psychol | Case manager2, SW | SEN | |||
NL | Psychologist | Case manager2, RN dem | ||||
ES | MD ger, psych, neuro, GP, psychol | RN, SW | ||||
SE | MD ger, psych, neuro, GP, psychol | |||||
E | Psychologist | RN, RN dem, psych, SW, OT | Support worker | |||
Caregiver support: Organization where professionals provide support, such as counseling, individually and/or in groups, and provide home visits to informal caregivers. | EE | Psychologist | SW | |||
FI | RN, RN dem | Aux-N | ||||
FR | SW | |||||
DE | Case manager2 | |||||
NL | Psychologist | Case manager2,, RN, SW | Ass-N | |||
ES | GP, Psychologist | RN,SW | ||||
SE | MD ger, psych, neuro, GP, Psychol | LPN | ||||
E | Psychologist | RN, RN dem, psych, SW, OT | ||||
Caregiver education: Training for informal caregivers providing care and service to PwDs. Education about needs and symptoms of dementia. | EE | MD | RN, SW | |||
FI | RN, RN dem, SW | Aux-N | ||||
FR | MD-ger | RN, SW | ||||
DE | Case manager2 | |||||
NL | Case manager2, RN, SW | |||||
ES | GP, Psychologist | RN, SW, OT | ||||
SE | RN, RN dem, SW | |||||
E | Psychologist | RN, RN dem, psych, SW | LPN | |||
Informal caregivers – reimbursed: Informal caregiver employed by the public to provide care and service. | EE | |||||
FI | RN, RN dem, SW | |||||
FR | MD ger, GP | SW | ||||
DE | ||||||
NL | NA1 | NA1 | NA1 | NA1 | NA1 | |
ES | SW | |||||
SE | SW | |||||
E | SW | |||||
Day care/day activity/day care center/day hospital: Clinic or agency providing social activities and activities to stimulate physical, mental, and intellectual functional ability, daytime | EE | |||||
FI | GP | RN, SW, Physio-T | ||||
FR | MD-ger. Psychologist | RN, SW, OT, Physio-T | ||||
DE | SW, Physio-T | SW, OT, Physio-T | SEN | Aux-N | Ass-N | |
NL | Multi-prof. team3 | |||||
ES | MD-ger, psych, neuro, GP, Psychologist | RN, SW, OT, Physio-T | Ass-N | |||
SE | SW | Ass-N, LPN | ||||
E | MD-psych, Psychologist | RN, RN dem, SW, OT, Physio-T | Ass-N | |||
Day care/day activity/day care center/day hospital specialized in dementia care: Clinic or agency, staff specialized in dementia care providing social activities and activities to stimulate cognitive ability, daytime. Only persons with dementia are admitted. | EE | OT | ||||
FI | RN, SW | Aux-N | ||||
FR | MD-ger. Psychologist | RN, SW, OT, Physio-T | ||||
DE | Multi-prof. team3 | Multi-prof. team3 | ||||
NL | Multi-prof. team3 | Multi-prof. team3 | ||||
ES | MD-ger, psych, neuro, GP, psychol | RN, SW, OT, Physio-T | ||||
SE | SW | Ass-N, LPN | ||||
E | MD-ger, psych, Psychologist | RN, RN dem, SW, OT, Physio-T | Ass-N, Support worker | |||
Respite care: For older people, but not specific to those with dementia disease: residential care around the clock for relief to informal caregivers who provide care for a family member/close friend. | EE | RN | ||||
FI | GP | RN | Aux-N | |||
FR | GP, MD-ger | SW | ||||
DE | SW, OT | SEN, SEN dem | ||||
NL | Multi-prof. team3 | Multi-prof. team3 | ||||
ES | MD-ger, psych, neuro, GP, psychol | RN, SW, OT, Physio-T | ||||
SE | GP | RN | Ass-N, LPN | |||
E | Support worker | |||||
Respite care, specialized in dementia care: Residential specialized dementia care around the clock for relief to informal caregivers who provide care for a family member/close friend. In a nursing home or residential home. | EE | RN | ||||
FI | GP | RN | Aux-N | |||
FR | GP, MD-ger | SW | ||||
DE | ||||||
NL | Multi-prof. team3 | Multi-prof. team3 | ||||
ES | ||||||
SE | GP | RN | Ass-N, LPN | |||
E | RN, RN dem | Support worker | ||||
Respite care at home: Care at home for relief to informal caregivers who are caring for a family member/close friend. | EE | |||||
FI | Aux-N | |||||
FR | ||||||
DE | ||||||
NL | Multi-prof. team3 | Multi-prof. team3 | ||||
ES | ||||||
SE | Ass-N, LPN | |||||
E | RN, RN dem | Support worker |