Needs-appropriate services for people with young onset dementia: The perspectives of healthcare professionals

Young onset dementia has become a growing challenge in national healthcare systems. Concerns about the situation have already been expressed; however, they mostly report the views of services end-users. Aimed at finding out useful further improvement, interviews documenting the working experiences of professionals addressing healthcare services to people with young onset dementia (YOD) were analysed qualitatively. The interviews resulted in four themes and twelve categories. The themes regarded services' complexity and responsiveness, the levels of education and knowledge on YOD, the impact that serving people with YOD reflects on staff working experience and quality of life, and a series of proposals aimed at improving services by giving people with YOD and families the provision of care they deserve. Although some of the themes recapped the ones reported in the previous literature, the mixture of internally and externally driven instances represented in the themes depict the complexity of care delivery in the services. Findings are discussed in the light of a pragmatical framework capable of suggesting what changes services should implement to be timely responsive.

Inclusion of Caregivers in Veterans' Care: A Critical Literature Review

More direct inclusion of informal caregivers (i.e., family, friends) in patients' care will make care more patient- and family-centered and has the potential to improve overall quality of care for patients. We need to understand what potentially comprises "inclusive care" so that we can define what "inclusive care" is and develop targets for care quality metrics. We conducted a critical literature review to identify key components of "caregiver inclusion." Focusing on extant literature from 2005 to 2017, 35 papers met inclusion criteria. Directed content analysis with constant comparison was used to identify major themes related to a concept of "inclusive care." Our analysis indicates that "inclusive care" entails five components: clear definition of caregiver role, system level policies for inclusion, explicit involvement of caregiver, provider assessment of caregiver capability, and mutuality in caregiver-provider communication. We discuss the evidence behind these five components using the Donabedian health care quality conceptual model.

Using Policy to Improve Access to Care for Persons With Alzheimer's Disease

As Americans increase life expectancies, one disease that has captured federal attention is Alzheimer's disease. Annually, health care professionals see provider billing codes changing to meet regulatory guidelines. In 2017, the Centers for Medicare & Medicaid Services enacted billing code G0505 to provide health care reimbursements for care planning services for clients with Alzheimer's disease. In-depth assessments and screenings included a patient-centered approach with familial interventions. Due to lack of awareness, health care providers demonstrated <1% use of these assessments in eligible older adults. Congress has proposed a bill (H.R. 1873/S880) to promote provider awareness and education training on its key elements. By educating future health care providers on updated legislation, providers will be able to offer an interdisciplinary approach in meeting the health care needs of the aging population. Health care providers can maintain patient advocacy while creating a vision of change for enabling policies specific to identified demographic populations. [Journal of Gerontological Nursing, 45(12), 7-11.].