Tailor-made services: Cooperation and supervision are essential for older people with dementia and challenging behaviour

Abstract

Dementia is a public healthcare priority in Norway. The aim of this study was to explore and describe users’ and professionals’ experiences of a Norwegian ambulatory psychiatric team treating older people with dementia and challenging behaviour. Patients with symptoms such as anxiety, depression, and agitation need special health care, which they rarely receive. Caring for these patients can be a burden for both relatives and nursing home staff. Little is known about the organisation of healthcare services for older persons with dementia and behavioural and psychiatric symptoms living at home or in a nursing home. The need for psychogeriatric teams that offer ambulatory services is in great demand. Such services might be particularly needed in rural districts, because the team we studied is unique in our region. This qualitative study involved interviews with relatives, ambulatory team members, and staff from four nursing homes. The analyses were inspired by systematic text condensation. Ambulatory team members developed a close relationship with patients, their relatives, and nursing home staff. This bonding made it possible to develop a tailor-made service for each patient. Staff in nursing homes wanted to be observed and to receive feedback about their daily care of patients. Relatives believed that their contributions were important and that health services needed to understand their limited resources. All informants agreed that better cooperation among healthcare levels was crucial for improving these services. More research and national guidelines are needed to determine how municipalities can best provide services for older people with dementia and psychiatric symptoms.