Care assessment process of dementia clients by community nurses

Abstract

Background: People with dementia require a high level of care and this care is mostly provided by informal caregivers with support from professionals. The growing population of elderly people was reason for a policy change that has led to a transition in care since January 2015. Specialized dementia care is now performed by community nurses and community nurses also assess care for clients with dementia since January 2015. Recent research shows that since the transition took place, there has been a decrease in assessments and prescriptions in specialized dementia care. Aim: The purpose of this study is to describe how community nurses shape the care assessment process for dementia clients in primary care and to identify the experience of community nurses with care assessments for dementia clients in primary care. Methods: A qualitative approach was chosen. The research sample consists of fifteen community nurses working in primary care in the Netherlands. Data collection and analysis were carried out between January 2016 and April 2016. Data collection consists of observations and interviews with community nurses. Observations and interviews were analysed using the QUAGOL method. Results: In the analysis, five main topics were discovered; care needs, dementia process and symptoms, community nurses and specialized dementia care, structured list and education. Conclusion: Classification methods used by community nurses are only focussed on activities of daily living. Community nurses do not have the knowledge and tools to assess the full spectrum of care needs of clients with dementia. Recommendations: Research is needed to develop a dementia tool for care assessments, which embodies the full spectrum of dementia care. Community nurses need education to be able to assess specialized dementia care.