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Stakeholders’ perspective on issues and challenges associated with care and treatment of aging-related cognitive impairment disorders in Singapore

Published online by Cambridge University Press:  20 June 2011

Monika Setia ,
Amina M. Islam ,
James P. Thompson  and
David B. Matchar
Monika Setia*
Affiliation:
Program in Health Services and Systems Research, Duke-NUS Graduate Medical School, Singapore
Amina M. Islam
Affiliation:
Program in Health Services and Systems Research, Duke-NUS Graduate Medical School, Singapore
James P. Thompson
Affiliation:
Program in Health Services and Systems Research, Duke-NUS Graduate Medical School, Singapore
David B. Matchar
Affiliation:
Program in Health Services and Systems Research, Duke-NUS Graduate Medical School, Singapore Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
*
Correspondence should be addressed to: Monika Setia, PhD, Program in Health Services and Systems Research, Duke-NUS Graduate Medical School, 8 College Road, Singapore – 169857. Phone: +65 660 11587; Fax: +65 653 48632. Email: [email protected].
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Abstract

Background: An expanding elderly population poses challenges for the provision of care and treatment for age-related physical and mental disorders. Cognitive impairment (CI)/dementia is one such mental disorder that is on the rise in Singapore and has concomitant implications for social and health systems. The objective of this study is to understand the perspectives of prominent stakeholders about current and future issues and challenges associated with CI/dementia among the elderly in Singapore.

Methods: Using indepth interviews, this qualitative study obtained the views of multiple stakeholders on issues and challenges associated with CI/dementia in Singapore. The 30 individuals interviewed as part of the study included clinicians, policy-makers, researchers, community workers, administrators, and caregivers. Using a framework approach, interview texts were indexed into domains and issues by utilizing NVivo 9.0 software.

Results: The stakeholders expressed concerns related to multiple domains of the CI/dementia care system: attitude and awareness, economics, education, family caregiving, inputs to care system, living arrangements, prevention, screening and diagnosis, and treatment and management of care. Within each domain, multiple issues and challenges were identified by respondents.

Conclusions: The study identifies a complex set of inter-related issues and challenges that are associated with the care and treatment of people with CI/dementia. The results suggest that CI and dementia profoundly affect patients, families, and communities and that the issues related to the two disorders are truly system-wide. These findings lay the foundation for utilization of a systems approach to studying CI/dementia and provide an analytic framework for future research on complex health care issues.

Keywords

dementiasemi-structured/open-ended interviewqualitative data analysissystems perspectivepolicy and practice domains
Type
Research Article
Information
International Psychogeriatrics , Volume 23 , Issue 9 , November 2011 , pp. 1421 - 1432
Copyright
Copyright © International Psychogeriatric Association 2011

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