The SiDECar ("Skills in DEmentia Care") project: an in-depth analysis of national dementia policies across Europe

Abstrakt

Background Although psychosocial interventions are receiving increased validation, actions to translate evidence into practice are inconsistent. This study is one pillar of the Erasmus+ project entitled "Skills in DEmentia Care - Building psychosocial knowledge and best practice in dementia care" (SiDECar).

In light of the importance of policies in establishing what is needed to meet dementia challenges, the aim of this study was to analyze European national strategies/plans to check whether they include references or full sections devoted to psychosocial care. The amount and content of the information along with its coherence with scientific evidence were investigated.

Methodology European strategies/plans were searched on the "Alzheimer Europe" and the "Alzheimer Disease International" websites and, if not available, Google and Google Scholar were used. Keywords were: "psychosocial care", "psychosocial interventions", "non-pharmacological care", "non-pharmacological interventions" and "non-medical".

A thematic analysis was carried out to identify: a) main dimensions associated with the topic of psychosocial care, and b) ways of psychosocial interventions delivery. An ad-hoc table was also developed to collect information on the following features relevant to clinical practice: a) type of psychosocial interventions; b) target population/s); c) staff qualifications; d) agencies or services involved in the provision of psychosocial care.

Results The area of psychosocial interventions was addressed by 18 documents out of 28 found across Europe. Main dimensions were: "Quality of care" and "Education/Training".

Psychosocial interventions were just mentioned as an appropriate care in Finland, Israel, Switzerland and Wales. The remaining documents provided information on ways of psychosocial interventions delivery which were classified as follows: "Referral of non-pharmacological approach", "Person-centred diagnosis and care", "Guidelines implementation", "Education and training programs", "Networking and strengthening of health and social services".

As for the other categories, almost no mention was made of type of interventions, professionals and services involved and, if available, it was not in line with scientific evidence. Discussion Overall, European dementia policies are characterized by high fragmentation, incompleteness and low systematization.

Indeed, in 10 out of 28 policy documents no mention of psychosocial interventions was found and, as for remaining documents, it is still unclear what such provision would actually look like, how it would be enabled, and how it would be assessed. In order to improve people with dementia and their carers' quality of life, multiple and simultaneous actions are needed.

Among them, as to be effective, policies should be based on a comprehensive and well-integrated system of bio-psychosocial care.