Background: In many communities around the world, informal caregivers of older adults with dementia represent an essential, yet often underappreciated, source of long-term care. The present study aimed to determine the personal experiences of such caregivers, which could be instrumental for developing means of improving the quality of care for both care receivers and their informal caregivers. Methods: Five semi-structured focus-group discussions were held. The participants (n = 31) were all informal caregivers of older adults with dementia. The focus-group discussions were audio-recorded and transcribed verbatim. An inductive approach was used, and thematic data analysis was applied. Results: Four thematic categories were identified: learning caregiving through personal experience; implications of caregiving on social wellbeing; caregivers’ contradictory emotions regarding care delivery; and addressing challenges regarding care provision. Conclusions: This study revealed, among the informal caregivers, a variety of experiences, contradicting feelings, and problem-solving strategies relating to the care of older adults with mental disorders. Becoming an effective caregiver involves professional and psychological development. Developing caregiving skills, supportive environment and positive attitude can help facilitate providing care. Caregiving largely impacts the emotional, physical, and social wellbeing of the person; thus, comprehensive approaches are needed to prevent burnout and associated social disadvantages.

Changes in the demographics and respective growth of life expectancy and social needs make informal caregiving crucial component of comprehensive health and social care network, which substantially contributes to the health and well-being of the elderly. The purpose of this paper is to understand the system of care of elderly patients with mental disorders from the perspective of informal caregivers in Lithuania. We conducted five semi-structured focus group discussions with 31 informal caregivers attending to elderly patients with mental disorders. The data were audiotaped and transcribed verbatim. A thematic analysis was subsequently performed. Five thematic categories were established: (1) the current state of care-receivers: representation of the complexity of patients’ physical and mental condition. (2) The current state of caregivers: lack of formal caregivers’ integration as a team; inadequate formal involvement of informal caregivers. (3) Basic care needs: the reflection of the group needs relating directly to the patient, care organisation and the caretaker. (4) The (non-) Readiness of the existing system to respond to the needs for care: long-term care reliance on institutional services, lack of distinction between acute/immediate care and nursing, lack of integration between the medical sector and the social care sector. (5) Potential trends for further improvement of long-term care for the elderly with mental disorders. Strengthening of the care network for elderly patients with mental disorders should cover more than a personalised and comprehensive assessment of the needs of patients and their caregivers. Comprehensive approaches, such as formalization of informal caregivers’ role in the patient care management and planning, a more extensive range of available services and programs supported by diverse sources of funding, systemic developments and better integration of health and social care systems are essential for making the system of care more balanced.

During past decades the science of collaboration in health care has progressed significantly worldwide, although in some regions (e.g.: Central and Eastern Europe) these processes are slower. The aim of this study was to develop a new, multidimensional measurement tool of the developing collaboration in primary health care (PHC). This study included both qualitative (thematic analysis of the data from focus group discussions) and quantitative (a 36-item cross-sectional questionnaire) methods in order to develop and test a new measurement scale. The collaboration scale between community nurses (CNs) and general practitioners (GPs) in primary health-care teams (COPAN scale) was created. It initially revealed five determining factors: “Goal Oriented Team Synergy”, “Team Structure and Leadership”, “Organizational Background for Teamwork”, “Competence” and “Diffusion of Functions.” Two and three-factor scales (COPAN-2 and COPAN-3) were developed after confirmatory factor analysis with sufficient psychometric characteristics to be applied in practice. This study reports the reliability of a novel tool that can be used to measure collaboration of CNs and GPs in PHC. The newly developed scale has the potential to become an easy-to-use tool in the monitoring of teamwork situations within PHC settings of low integration or newly evolving teams.

Dementia is considered to be a significant cause of disability and dependency for older people worldwide and it raises difficulties in providing adequate formal and informal assistance. Research on the experience of long-term care (LTC)services for older people with dementia is scarce in Eastern European countries. This study aimed to understand the system of care for older people with dementia from the perspective of health and social care workers providing LTC services in Lithuania. A total of 72 primary health care and social care professionals from public and private institutions in Kaunas city participated in this study. One-to-one interviews were conducted with family physicians, community nurses, psychiatrists, psychiatric nurses, and social workers. A vignette situation of 2 fictitious patients with dementia and their informal caregiver was discussed during the interviews. Data were analyzed using thematic analysis by induction approach. The data revealed 2 main themes: LTC provision trajectory, and three-dimensional relationship perception in realization of LTC activities. LTC provision trajectory reflected activities performed as a response to the described situation embracing formal procedures for the endorsement of LTC needs as well as the range of LTC services. The three-dimensional perception of relationships in LTC services’ implementation reflected the participants’ personal approach toward LTC, relationship with different specialists, and the informal caregiver. Our study revealed the potential of complex measures that could be instrumental for the refinement of the caregiving process. First, a change in the additional care requirements endorsement logic is needed, shifting focus from medical diagnosis to functional abilities assessment. Second, to establish clear procedures for formal cooperation between the health and social care sectors in the trajectory of LTC service provision. Finally, to find an adequate balance between LTC and institutional care by creating a more comprehensive range of LTC services. A more consistent and coordinated delivery of services by both health and social care sectors seems to be an untapped resource for the improvement of the LTC potential.

Background In many communities around the world, informal caregivers of older adults with mental disorders (such as dementia) represent an essential, yet often underappreciated, source of long-term care. The present study aimed to determine the personal experiences of such caregivers, which could be instrumental for developing means of improving the quality of care for both care receivers and their informal caregivers.Methods Five semi-structured focus-group discussions were held. The participants (n = 31) were all informal caregivers of older adults with mental disorders. The focus-group discussions were audio-recorded and transcribed verbatim. An inductive approach was used, and thematic data analysis was applied.Results Four thematic categories were identified: learning caregiving through personal experience; implications of caregiving on social wellbeing; caregivers’ contradictory emotions regarding care delivery; and addressing challenges regarding care provision.Conclusions This study revealed, among the informal caregivers, a variety of experiences, contradicting feelings, and problem-solving strategies relating to the care of older adults with mental disorders. Becoming an effective caregiver involves professional and psychological development, but also requires a relevant educational background, a positive attitude, and a supportive environment. Caregiving largely impacts the emotional, physical, and social wellbeing of the person; thus, comprehensive approaches are needed to prevent burnout and associated social disadvantages.

The aging population and overstretched healthcare systems are increasing demand for home nursing by informal caregivers, significantly affecting their mental health. This study aimed to examine the level of population’s engagement in caregiving and the association between high-intensity caregiving and perceived caregiving stress in the general population of Lithuania. A nationally representative sample (N = 1000) of Lithuanian residents aged 18 years and older (mean age 53.1 ± 17.9 years) was interviewed in their households. The results showed that 17.4% (95% CI: 15.1, 19.8) of respondents were involved in home nursing activities to some extent, with 42% of these being high-intensity caregivers (providing 11 or more hours of home care per week). Caregivers were statistically significantly more likely to be female and have higher education levels. Perceived stress was significantly associated with higher education levels (OR = 2.66, 95% CI: 1.41, 5.02), high-intensity caregiving (OR = 2.14, 95% CI: 1.15, 3.97), regular involvement in home nursing (OR = 1.86, 95% CI: 1.01, 3.43), and caring for recipients with dementia or individuals entirely dependent on assistance (OR = 2.52, 95% CI: 1.22, 5.23). Caregivers perceived stress is associated with their level of education, the intensity and regularity of home nursing, as well as the level of dependency of the care recipient, especially in cases of dementia. Comprehensive long-term care policies should be developed to ensure the larger availability of formal care resources, increased societal participation in home nursing, and tailored interventions for high intensity caregivers.