Cross-Border Capacity Assessment in Dementia Care.

Within the Euregio Meuse-Rhine, cross-border cooperation in the healthcare sector has taken place on different occasions and at different levels. However, it still proving to be difficult to have an overview of the existing structures and activities of Euregio in specific healthcare fields, such as for instance, dementia care. The aim of this study is to examine to what extent cooperation in the Dutch province of Limburg in the field of dementia care can be considered Euregionally oriented. In order to create more cross-border transparency within the Euregional dementia care field, we conducted a capacity assessment analysis. Capacity assessment is the first step in the further development of healthcare capacities by mapping current as well as desired capacities. Although we related the model as applied in this study explicitly to dementia care in the Euregio Meuse-Rhine, the model could be applicable in other cross-border settings and/or healthcare fields as well. Despite the apparently well-functioning system of regional dementia care networks in the Dutch province of Limburg, none of the respondents declared to have structural contacts with similar organizations in the other (German and Belgian) parts of the Euregio. Moreover, many of our respondents argued that cross-border cooperation in the field of dementia care could be interesting in various ways, but at the same time there is currently no direct necessity to actively pursue such cooperation. Despite the absence of structural cross-border cooperation initiatives in the field of dementia care in the Euregio Meuse-Rhine, some suggestions can be made for the formulation of a potential capacity development response on the basis of the results of the capacity assessment as conducted in this study (showing gaps between current and desired capacities). Even if it is subsequently decided not to formulate a concrete capacity development response (for example due to the lack of a mutual objective need amongst organizations to engage in cross-border cooperation), a capacity assessment offers at the least a reflection on an organization's own performance as well as providing transparency between organizations. The main opportunities for the formulation of a capacity development response on a Euregional level in the field of dementia care are related to knowledge development and the creation of partnerships.

Exploring the impact of austerity-driven policy reforms on the quality of the long-term care provision for older people in Belgium and the Netherlands.

In this case study, European quality benchmarks were used to explore the contemporary quality of the long-term care provision for older people in the Belgian region of Flanders and the Netherlands following recent policy reforms. Semi-structured qualitative interviews were conducted with various experts on the long-term care provision. The results show that in the wake of the economic crisis and the reforms that followed, certain vulnerable groups of older people in Belgium and the Netherlands are at risk of being deprived of long-term care that is available, affordable and person-centred. Various suggestions were provided on how to improve the quality of the long-term care provision. The main conclusion drawn in this study is that while national and regional governments set the stage through regulatory frameworks and financing mechanisms, it is subsequently up to long-term care organisations, local social networks and informal caregivers to give substance to a high quality long-term care provision. An increased reliance on social networks and informal caregivers is seen as vital to ensure the sustainability of the long-term care systems in Belgium and in the Netherlands, although this simultaneously introduces new predicaments and difficulties. Structural governmental measures have to be introduced to support and protect informal caregivers and informal care networks.

Social networks, social participation and self-perceived health among older people in transitional Kosovo.

BACKGROUND: A number of studies proved that social networks and social participation have beneficial health effects in western countries. However, the evidence from southeast European region is scant. We aimed to assess the extent of social networks and social participation and their relationship with self-perceived health status among older people in post-war Kosovo. METHODS: A nationwide cross-sectional study was conducted in Kosovo in 2011 including a representative sample of 1890 individuals aged ≥65 years (949 men, mean age 73 ± 6 years; 941 women, mean age 74 ± 7 years; response rate: 83%). Social networks were assessed by means of number of friends and family members that participants had contacts with, whereas social participation by involvement in social groupings/organizations. Information on self-perceived health status and demographic and socioeconomic characteristics was also collected. RESULTS: Overall, 93% of study participants reported that they had at least weekly contacts with more than one family member, and 97% reported daily contacts with their respective friends. Conversely, only 14% of participants reported engagement with social groupings. Generally, individuals who had contacts with friends and/or engaged with social organizations reported a better health status. CONCLUSION: Our findings point to strong family ties in this patriarchal society. Conversely, levels of social participation were considerably lower in Kosovo compared with the western European countries. The low participation levels in social groupings and their putative deleterious health effects should raise the awareness of policymakers to improve the conditions and increase the degree of social participation among older people in transitional Kosovo.