[Examining the perspective of community general support centers and promoting the use of early stage dementia-intensive support teams: Comparing institutions with and without support teams].

Abstract

Objectives　Although numerous studies have explored early stage dementia-intensive support teams, focusing on their effectiveness and associated challenges, there is insufficient research on community comprehensive support centers that use support teams. Thus, we focused on community comprehensive support centers from the perspectives of their operators and users, examined the actualities and challenges of support team use, and considered ways to encourage such use.Methods　A questionnaire survey was mailed to 2,000 community general support centers selected through evenly-spaced sampling from 5,625 centers in Japan. The survey was conducted from November to December 2022. The survey included basic attributes (institution and presence of a support team), number of times a support team was used, actual number of users, and issues with support team use. For the analysis, we defined centers with and without support teams as "operators" and "users," respectively, and analyzed each group. The participants' demographic details and data related to the frequency of use of support teams were tabulated. Text mining was used to analyze free-field responses.Results　A total of 773 responses were received (response rate; 38.8%). Among the respondents, 313 (41.5%) had support teams and 441 (58.4%) did not. The support team use rate was 86.6% for the former and 79.4% for the latter. In 2021, most respondents noted that approximately "1-5 individuals" used support teams, regardless of whether the support center had one.Challenges with support team use identified by centers without support teams were as follows; requirements of support recipients and rules for use under "mechanisms of use," involvement of team doctors and expertise of team members under "support functions," and collaborative support relationship and dissemination of project information under "system for use." Support centers with support teams identified the following challenges; requirements of support recipients and management rules under "management mechanisms," involvement of team doctors and healthcare collaboration under "support functions," and team members role awareness and staff shortage under "management system."Conclusion　Many comprehensive centers infrequently used support teams. To promote support team use, the system must be reviewed from the operator and user perspectives to simplify the support team system's rules and ease the requirements for support recipients. Moreover, all dementia supporters must engage in regular and ongoing discussions about the dementia support system, focusing on the municipal responsibility for system operation.