Dementia care in the context of primary care reform: an integrative review
Abstract
OBJECTIVES: The purpose of this review was to determine the influence of the growing body of evidence about the attributes of high-performing primary care systems on the literature related to the primary care of people living with dementia. METHODS: In this integrative review, we examined a broad range of published and grey literature (2000-2013) about the primary care of dementia, using a systematic approach set up in advance of the literature search. The review was guided by two questions: What are the evident models of primary care for dementia? How do the models line up with the other attributes of high-performing primary care? RESULTS: Three models were noted: carved-out, co-managed, and integrative-hub, all informed by different assumptions about the role of primary care in dementia. The models varied in alignment with the attributes of high-performing primary care, although we found very little attention to accessibility, relational continuity or comprehensiveness of care. CONCLUSIONS: We know what we need to pay attention to in building our primary care system - and no population will put the performance of primary care more to the test over the next two decades than the rapidly growing number of people who will be living with complex chronic conditions like dementia. Recent literature around primary care and dementia shows promise in attending to some of the attributes of high-performing primary care, yet much more work is needed if we are to truly leverage the potential value of primary care in addressing the needs of these complex and numerous future patients.
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Primary healthcare plays a critical role in rural dementia care due to lack of specialists and the importance of care coordination post-diagnosis.
“Primary healthcare plays a critical role in rural dementia care due to lack of specialists and the importance of care coordination post-diagnosis [24, 25], thus effective models of primary healthcare for dementia in rural settings are needed [26], along with strategies for translating these into practice and ensuring sustainability.”
From Factors influencing sustainability and scale-up of rural primary healthcare memory clinics: perspectives of clinic team members (2022) · cites this paper as [25]
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- Authors
- Spenceley, S. M., Sedgwick, N., & Keenan, J.
- Affiliations
- University of Lethbridge (CA)
- Corresponding author
- Spenceley, Shannon M.
- Venue
- Aging & Mental Health
- Publisher
- Informa UK Limited
- Published
- 2014-06-05
- Volume
- 19
- Issue
- 2
- Pages
- 107-120
- ISSN
- 1360-7863 (ISSN-L)
- 1364-6915
- OpenAlex
- W2076202220
- Cited by
- 35
- References
- 49
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 3 · 2023: 5 · 2022: 2 · 2021: 6 · 2020: 3 · 2019: 5 · 2018: 3 · 2017: 1 · 2016: 2
- FWCI
- 0.17
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Aging & Mental Health (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Keywords
- dementia care, primary care reform, primary care models, co-management, relational continuity, care accessibility, comprehensiveness of care, complex chronic conditions
- MeSH terms
- Dementia, Humans, Primary Health Care, Quality of Health Care, Models, Organizational
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