Do national guidelines have any impact? A comparison of nine Swedish municipalities and the Dementia care

ABSTRACT

The aim of this article is to find out what impact national guidelines have on municipality dementia care. Furthermore, the aim is to compare organization of social care to the local adaptation of nationally invoked values. This article is connected to Living with dementia, care and social care systems, an interdisciplinary project between Health Sciences at Lund University and Social Sciences at Linnaeus University. The national guidelines for care and services to people with dementia recommend specialized units, and professional specialization in dementia care. Based on values of self-determination, integrity, accessibility, equity, rights and safety, they are meant to guide the dementia care in the community. In this article the organization of care is compared to how nationally invoked values are discussed in local policy documents in nine municipalities. These two aspects of dementia care are central to the national guidelines. The organization of care was explored by a mapping study of 19 municipality services. Type of organization was determined based on when, throughout the progression of the disease, services were made available, the existence of specialized dementia care units, and level of professional specialization. Information about values in local policies was examined by utilizing policy as discourse analysis of local policy documents. Four types of relationships between organization and value implementation were found. Eight out of nine municipalities failed to adapt to both aspects of the national guidelines.

KEYWORDS:

• Community care
• dementia
• national guidelines
• organization
• specialization
• values

Acknowledgments

This study was a part of the inter disciplinary project LwD, conducted by the department of social work at Linnaeus University and the department of Health, care and society at Lund University. It was funded by The Kamprad family foundation. The study was carried out in the research environment of Research on Elderly in social Sciences (REIS) at Linnaeus University.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Kamprad Family Foundation for Entrepreneurship, Research and Charity;