gms | German Medical Science

Background/research question: The progressive character of dementia usually leads to an increasing need for support. However, access to and use of professional support take place lately. Aspects influencing access to and use of formal care are often investigated, but an overview from a professional perspective is missing. We aim to provide an overview of aspects influencing access and use of formal care in dementia from the perspective of health- and social care professionals. Additionally, the perspectives of professionals and people with dementia/informal carers and those of two selected professions will be compared.

Methods: We conducted a scoping review with a systematic literature search in Medline via Ovid in January 2019 and updated in April 2020. After the screening, the focus for the in-depth investigation narrowed down to nurses and physicians. All included publications were critically appraised using the Mixed Method Appraisal Tool. We analysed influencing aspects and formal care and support services. Our findings were narratively described and discussed with trained dementia care nurses (DCN).

Results: We identified a total of 21 studies: n=16 qualitative, n=4 quantitative-descriptive, n=1 mixed-methods. A large number of various support services were identified. Some studies examined specific care contexts, e.g. primary or community care or mental health specialists. More than half of the studies examined the perspective of a specific professional group: n=10 physicians and n=2 nurses. A wide range of aspects (n=15) influence the access and use of formal care services. Frequently addressed were aspects relating to the complexity and structure of the healthcare system, the competence of professionals and attitudes, expectations and experiences of people with dementia and their informal carers towards dementia and services. The DCNs highlighted the importance of coordinated care and to enhance dementia-specific competencies.

Conclusion: Coordinated dementia-specific care is necessary to provide adequate support to people with dementia and their relatives. Several professions may be involved in this increasingly important field of activities, e.g. nurses with a dementia-specific training like the DCNs. However, the nurses’ perspectives on access to and use of formal dementia care were rarely examined compared to physicians’ perspectives. Therefore, nurses and other health and social care professions should be considered in dementia care research.

Competing interests: The authors declare that they have no competing interests.