Feasibility of a new community-based geriatric intervention programme: An exploration of experiences of GPs, nurses, geriatricians, patients and caregivers

Abstract

Purpose. To determine the feasibility of the Dutch Geriatric Intervention Programme (DGIP) in primary care. Within the DGIP, a nurse cooperates with a General Practitioner (GP) and a clinical geriatrician to assess and manage care for community-living older patients. The aim of this study was to describe both views of care receivers and those of professionals in order to identify facilitating factors and barriers for implementation of the DGIP.

Method. Combined quantitative and qualitative data collection methods were used. Pre- and post-questionnaires were taken from GPs (n = 15), nurses (n = 6) and geriatricians (n = 2). These professionals were also interviewed. In addition patients (n = 11 out of total n = 54) and their carers (n = 37) were interviewed.

Results. GPs appreciated the support by the DGIP for problems in cognition, mood and mobility. Lack of knowledge and time restriction was the cause of their incapability at that point. In the cooperation between professionals, nurses felt that they had to initiate the contact. Personal contact helped the mutual communication. Involving the carer of the patient proved very important. All disciplines found this of crucial importance in order to deliver a tailored intervention and create conditions for optimal care. Barriers, for which the programme was tailored during the implementation, were: resistance in referrals of patients to the programme, nurses' and GPs' knowledge of diagnostic tests, communication problems and insufficient involvement of caregivers.

Conclusions. The implementation of the DGIP was feasible, but several barriers need ongoing attention by implementation, like communication between disciplines.

Keywords:

• Aged
• Frail elderly
• geriatric assessment
• health services for the aged nurse-physician communication