Non-use of community health-care services – an exploratory cross-sectional study among family care-givers for older, home-dwelling persons with dementia

• Published in: Ageing and Society
• Main Authors: Moholt, Jill-Marit, Friborg, Oddgeir, Henriksen, Nils Oddbjørn, Hamran, Torunn, Blix, Bodil Hansen
• Format: Article in Journal/Newspaper
• Language: English
• Published: Cambridge University Press (CUP) 2020
• Subjects: VDP::Medisinske fag: 700::Helsefag: 800; VDP::Midical sciences: 700::Health sciences: 800; VDP::Medisinske fag: 700::Helsefag: 800::Helsetjeneste- og helseadministrasjonsforskning: 806; VDP::Midical sciences: 700::Health sciences: 800::Health service and health administration research: 806; Demens / Dementia; Forskning på Helsetjenester / Health Services Research; Pårørende / Next of kin; Spørreskjemametodikk / Questionnaire design; Norway; Northern Norway
• Online Access: https://hdl.handle.net/10037/17711; https://doi.org/10.1017/S0144686X2000015X

Community health-care services for older, home-dwelling persons with dementia tend to be underutilised. Family care-givers provide substantial care, and they often arrange for and co-ordinate health-care services on behalf of persons with dementia. The aim of this study was to examine family care-givers’ knowledge of unused services and their self-reported reasons for non-use of such services. We gathered cross-sectional survey data from 430 family care-givers of older persons with dementia in Northern Norway. Multinomial logistic regression analysis was used to identify predictors of family care-givers’ knowledge of unused services. An open-ended question regarding reasons for non-use of services was analysed by thematic text analysis. Characteristics of family care-givers (e.g. education level) and factors related to the care-giving circumstances (e.g. negative impact of care-giving) predicted family care-givers’ knowledge of unused services. Reasons for non-use of services were multifaceted and complex, and were related to attributes of the person with dementia and/or the family care-giver (e.g. reluctance to use services) and/or the health-care services (e.g. low quality). Although services were unused, several family care-givers indicated substantial needs for the services. Strategies aimed at addressing the non-use of services should emphasise individuals’ and families’ needs and the adaptation of information about available services and their benefits for both care recipients and family care-givers. A relationship-centred care approach is thus recommended in dementia care.