CoChat
Sign Up
Cited by 18Dementia and Cognitive Impairment ResearchGeriatric Care and Nursing HomesAging, Elder Care, and Social Issues

Towards a community-based dementia care strategy: how do we get there from Here?

Morton-Chang, Frances, Williams, A. Paul, Berta, Whitney, Laporte, Audrey·2016·HealthcarePapers
DOI 10.12927/hcpap.2017.25006
Open this paper in CoChat — free account

Abstract

As recent policy reports in Ontario and elsewhere have emphasized, most older persons would prefer to age at home. This desire does not diminish for the growing numbers of persons living with dementia (PLWD). Nevertheless, many PLWD end up in residential long-term care (LTC) or in hospital beds. While LTC is valuable for PLWD with highly progressed cognitive and functional impairment requiring high-intensity care, it can be a costly and avoidable option for those who could remain at home if given early access to a coordinated mix of community-based supports. In this lead paper, we begin by exploring the "state of the art" in community-based care for PLWD, highlighting the importance of early and ongoing intervention. We then offer a brief history of dementia care policy in Ontario as an illustrative case study of the challenges faced by policy makers in all jurisdictions as they aim to re-direct healthcare systems focused on "after-the-fact" curative care towards "before-the-fact" prevention and maintenance in the community. Drawing on results from a "balance of care" study, which we conducted in South West Ontario, we examine how, in the absence of viable community-based care options, PLWD can quickly "default" to institutional care. In the final section, we draw from national and international experience to identify the following three key strategic pillars to guide action towards a community-based dementia care strategy: engage PLWD to the extent possible in decisions around their own care; acknowledge and support informal caregivers in their pivotal roles supporting PLWD and consequently the formal care; and enable "ground-up" change through policies and funding mechanisms designed to ensure early intervention across a continuum of care with the aim of maintaining PLWD and their caregivers as independently as possible, for as long as possible, "closer to home."

Integrity signals

Registry

Crossref · 10.12927/hcpap.2017.25006

Cites

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Limits on home care service and family availability were associated with long-term care placement.

    “Consistent with the literature [35–37], limits on home care service and family availability were associated with LTC placement.”

    From Towards defining quality in home care for persons living with dementia (2022) · cites this paper as [37]

Cited by

Sorted by citations

Related

Authors
Morton-Chang, F., Williams, A. P., Berta, W., & Laporte, A.
Affiliations
University of Toronto (CA)
ORCID
Venue
HealthcarePapers
Publisher
Longwoods Publishing
Published
2016-10-08
Volume
16
Issue
2
Pages
8-32
ISSN
  • 1488-917X (ISSN-L)
  • 1929-6339
DOI
10.12927/hcpap.2017.25006
OpenAlex
W2604989331
Cited by
18
References
0
Citations by year
2025: 2 · 2024: 1 · 2022: 5 · 2021: 2 · 2020: 1 · 2019: 3 · 2018: 2 · 2016: 1 · 2012: 1
FWCI
1.78
Type
journal article
Language
en
Open access
closed
Locations
  • A Nudge Too Far? A Nudge at All? On Paying People to Be Healthy (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
  • Health Sciences › Health Professions › General Health Professions › Aging, Elder Care, and Social Issues
Keywords
dementia care, community-based care, older adults, long-term care, institutional care, early intervention, dementia policy, Ontario, informal caregivers, caregiver involvement, continuum of care, aging at home
MeSH terms
Community Health Services, Dementia, Health Policy, Home Care Services, Humans, Ontario, Primary Health Care, Quality of Life, State Medicine, Caregivers, Patient-Centered Care

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review