Availability and Primary Health Care Orientation of Dementia-Related Services in Rural Saskatchewan, Canada

Figures & data

FIGURE 1 Number of home care assessors, based on query to home care directors, and population counts, by Health Region, Saskatchewan, 2013 (Saskatchewan Ministry of Health, 2013).

TABLE 1 Availability of Dementia-Related Services

Service	N	At least weekly n (%)	Less often than weekly n (%)	Not available n (%)
Health promotion programs
Recreational activities for older adults	71	58 (81.7)	9 (12.7)	4 (5.6)
Healthy lifestyle promotion related to dementia	70	8 (11.4)	10 (14.3)	52 (74.3)
Healthy brain promotion	69	5 (7.2)	10 (14.5)	54 (78.3)
Primary health care
Pharmacist	69	61 (88.4)	3 (4.3)	5 (7.2)
Family physician	71	60 (84.5)	5 (7.0)	6 (8.5)
Physical therapist	69	43 (62.3)	17 (24.6)	9 (13.0)
Occupational therapist	71	39 (54.9)	30 (42.3)	2 (2.8)
Other health care professionals	69	34 (49.3)	14 (20.3)	21 (30.4)
Social worker	70	33 (47.1)	19 (27.1)	18 (25.7)
Nurse practitioner	71	30 (42.3)	4 (5.6)	37 (52.1)
Screening of older adults for possible dementia	69	24 (34.8)	15 (21.7)	30 (43.5)
Multidisciplinary team assessment	70	18 (25.7)	12 (17.1)	40 (57.1)
Postdiagnosis support
Palliative care	71	65 (91.5)	4 (5.6)	2 (2.8)
Adult day program	71	54 (76.1)	2 (2.8)	15 (21.1)
Case management of diagnosed individuals	69	49 (71.0)	9 (13.0)	11 (15.9)
Volunteer services/visitors	70	36 (51.4)	13 (18.6)	21 (30.0)
Private caregiving	66	21 (31.8)	1 (1.5)	44 (66.7)
Other caregiver support	70	18 (25.7)	25 (35.7)	27 (38.6)
Counseling diagnosed individuals	71	15 (21.1)	17 (23.9)	39 (54.9)
Counseling caregivers	71	14 (19.7)	23 (32.4)	34 (47.9)
Patient registry (for individuals diagnosed with dementia)	69	6 (8.7)	5 (7.2)	58 (84.1)
Caregiver support group	69	3 (4.3)	23 (33.3)	43 (62.3)
Caregiver registry (for caregivers of individuals diagnosed with dementia)	65	1 (1.5)	3 (4.6)	61 (93.8)
Home care
Personal care—AM care	71	70 (98.6)	1 (1.4)	0
Personal care—Bath assist	71	70 (98.6)	1 (1.4)	0
Meals on Wheels	71	67 (94.4)	0	4 (5.6)
Meal prep	71	67 (94.4)	1 (1.4)	3 (4.2)
Personal care—Toileting	70	59 (84.3)	1 (1.4)	10 (14.3)
Personal care—HS Care	71	56 (78.9)	1 (1.4)	14 (19.7)
In-home respite and visiting	71	54 (76.1)	10 (14.1)	7 (9.9)
Homemaking	70	52 (74.3)	3 (4.3)	15 (21.4)
Planned respite care	69	48 (69.6)	20 (29.0)	1 (1.4)
Emergency respite	71	31 (43.7)	12 (16.9)	28 (39.4)
Transportation to health care	70	27 (38.6)	4 (5.7)	39 (55.7)
Weekend respite	70	24 (34.3)	10 (14.3)	36 (51.4)
Night respite	71	14 (19.7)	5 (7.0)	52 (73.2)
Long-term care*
Counseling for caregivers of individuals in LTC	64	10 (15.6)	11 (17.2)	43 (67.2)
Counseling for individuals with dementia in LTC	65	6 (9.2)	11 (16.9)	48 (73.8)

Note. N varies from 64 to 71 due to missing responses across items.

*Other long-term care services (seniors housing, nursing home, private care home, assisted living, dementia special care unit) are reported in the text because a different response set was used for these services.

TABLE 2 Primary Health Care Orientation of Dementia-Related Services Scales, Item Statistics

Attribute	M	SD (range)
Information and education
Adequate awareness about “what to do” or “where to go”	2.7	1.2(1−5)
Adequate information for caregivers	2.3	1.0(1−4)
Adequate awareness of dementia among health care professionals in the community	3.5	1.2(1−5)
Adequate dementia-specific continuing education for health care professionals	2.4	1.0(1−5)
Adequate public education to reduce stigma of dementia	1.8	0.8(1−4)
Accessibility
Appropriate frequency of services	2.5	1.1(1−5)
Appropriate wait time for services	2.8	1.2(1−5)
Available public transportation to services(for older adults)	2.9	1.5(1−5)
Available subsidized/free transportation to services(for older adults)	2.0	1.3(1−5)
Equally accessible services, regardless of geographic location	2.2	1.2(1−5)
Population orientation
Appropriate level of PHC services	2.3	1.0(1−5)
Appropriate level of home care services	3.0	1.1(1−5)
Appropriate number of LTC beds	2.6	1.3(1−5)
Appropriate telehealth services	2.8	1.1(1−5)
Appropriate level of support for caregivers	2.1	0.9(1−4)
Coordinated care
Service delivery by different health care professionals in the community is coordinated	3.4	1.1(1−5)
All health care professionals in the community have easy access to patient health history	2.9	1.3(1−5)
Health care professionals co-ordinate well with each other to manage patient care(within and outside community)	3.5	1.0(1−5)
Health care professionals co-ordinate well with community agencies to manage patient care(within and outside community)	3.2	1.0(1−5)
Seamless transition from community to LTC	2.9	1.2(1−5)
Comprehensiveness of care
One or more health care professional is able to diagnose	3.3	1.4(1−5)
One or more health care professional is able to provide on-going management	3.9	0.8(2−5)
There is timely referral to appropriate health and social services	3.2	1.0(1−5)
Multidisciplinary care is available	3.6	1.1(1−5)
Health care professionals consider dementia a chronic disease	3.6	1.1(1−5)
Quality of care
Timely diagnosis occurs	2.7	0.9(1−5)
Health care professionals use standardized diagnostic criteria	3.2	1.1(1−5)
Current screening tools are effective	3.4	0.8(1−5)
Care and management are guided by standardized care pathways	2.5	1.0(1−4)
Health care professionals adequately monitor safety of individuals with dementia living at home	2.9	1.1(1−5)

Note. N varies from 69 to 70 due to missing responses across items.

Scale scoring: 1 = no, not at all; 2 = no, not really; 3 = undecided; 4 = yes, to some extent; 5 = yes, to a very great extent.

TABLE 3 Primary Health Care Orientation of Dementia-Related Services Scales, Statistics, and Internal Consistency Reliability

Scale	n	M score (SD)	Range^a	Cronbach’s alpha^b
Information and education	70	12.7 (3.8)	6–23	0.78
Accessibility	69	12.4 (3.9)	6–22	0.58
Population orientation	70	12.7 (3.3)	5–21	0.60
Coordination of care	70	15.9 (3.6)	8–24	0.67
Comprehensiveness of care	70	17.5 (3.7)	7–25	0.74
Quality of care	70	14.5 (3.2)	8–21	0.69

Note. N varies from 69 to 70 due to missing responses across items.

^aAll scales have 5 items, rated on a 5-point scale (possible range 5–25).

^bCronbach’s alpha based on standardized items.

Saskatchewan Ministry of Health. (2013). Covered population 2013. Regina, Saskatchewan, Canada: Author.

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