Challenges for rural primary care teams in providing care for patients with dementia

Problem

Concerns about managing the healthcare needs of an aging population are growing. Predictions shows the number of people over 65 years old will grow by around 7% by 2025. With more people living longer there is a higher prevalence of chronic diseases. Significant amongst these related to dementia and its impact on the individual, caregivers and healthcare system. Currently 850,000 people in the UK have dementia with this expected to grow by 140% by 2050. Health and socialcare expenditure on people with dementia is expected to double within 20 years. Over the next decade the rural population is set to increase by 6 percent- with an upwards trend in deurbinsation- people moving from urban areas to the countryside as they get older. This will lead to an increase in elderly people in rural areas, and an increase therefore in chronic conditions such as dementia. Challenges of rural healthcare include distance to services, isolation, lack of internet/phone connectivity. These compounded with a diagnosis of dementia can result in a negative quality of life. Often the first point of contact for these patients, who could be living alone with no support, is their General Practitioner and Primary Healthcare Team. (PCT)General literature review suggests that some work has been done looking at challenges for carers of patients with dementia in rural areas but little specifically looking at the challenegs facing the multidisciplinary PCT.

Approach

The aim of this study is to identify the challenges, for the rural primary care team in providing care for patients with dementia and to identify ways in which care might be improved. 1. To identify challenges for the rural PCT in providing care for patients with dementia 2. To establish degrees of concordance and difference of challenges faced by rural PCTs providing care for patients with dementia in Northern Ireland and that revealed in the literature 3. To identify ways in which the rural PCT could improve care for patients with dementia

Findings

I have carried out a scoping review with the question - what is known about the challenges for rural primary care teams in providing care for patients with dementia. Results of this have shown a small number of studies mainly based in the USA and Australia. The challenges of geography, distance and access to specialist services, lack of community resources, stigma and lack of training for rural physicians were amongst the main findings. More detailed findings would be presented at the conference if successful.I am in the process of conducting focus groups in rural Northern Ireland. Results of these would be presented at the conference.

Consequences

I feel the findings will be pivotal in addressing future healthcare needs for patients with dementia living in rural and remote areas of northern Ireland and further afield.