Integrated Care Services for Dementia and Their Challenges from a Nursing Home Perspective: An Ethnographic Study.

Abstract

Background: The number of older adults living with dementia is increasing in China and worldwide. There is limited attention paid to dementia care in nursing homes, and this study aimed to explore the current situation and challenges of providing integrated care services in nursing home settings.

Methods: A 3-month focused ethnographic study, including semi-participatory observations and in-depth interviews, was conducted in a nursing home in Suzhou, China, from June to August 2022. Twelve residents and sixteen caregivers were observed, and sixteen observed caregivers were interviewed. The Rainbow Model guided data collection. Deductive analysis was used to examine the integrated care services, and a combination of deductive and inductive analysis was applied to explore the challenges.

Results: The Combination of Medical and Elderly care and Medical Consortia were two main integrated care services. Eighteen challenges that threatened integrated care were identified. The nursing homes mainly faced professional and clinical challenges, while Medical Consortia encountered challenges at all levels, especially the organizational level.

Conclusions: The integrated care services of residents living with dementia should be further strengthened. Policymakers, caregivers, and researchers should make more precise efforts to address the challenges that threaten integrated care services, thereby promoting better services for residents.