Integration of Dementia Systems in Central America: A Social Network Approach

TL;DR

This study explores dementia care systems in Central America using social network analysis to understand how integrated care can be improved for older adults.

Contribution

The paper introduces the use of social network analysis in evaluating dementia care systems in low and middle-income countries.

Findings

Dementia care systems in Central America show fragmentation and low integration.

Organizations have diversified connections but lack awareness of potential collaboration partners.

The study provides baselines for system structures and identifies resource needs for integration.

Abstract

Action 3 of the UN Decade of Healthy Ageing plan is to deliver integrated care to improve older adults’ lives. Integrated care is vital in meeting the complex needs of people with dementia but little is known about how this is or could be delivered in low and middle income countries (LMIC). This paper provides insights into previously unknown care system structures and on the potential and reality of delivering integrated care in Central America for people with dementia.

A social network analysis (SNA) methodology was adopted to engage with providers of services for older adults and families with dementia in Guatemala, El Salvador, Honduras, Costa Rica and Panama. Sixty-eight (68) semi-structured interviews were completed, 57 with organisations and 11 with families.

Across the five countries there was evidence of fragmentation and low integration within the dementia care systems. A variety of services and types of providers are present in all five countries, and high levels of diversified connections exist among organisations of differing disciplines. However, unawareness among network members about other members that they could potentially form active links with is a barrier on the path to integration.

This innovative and robust study demonstrates SNA can be applied to evaluate LMIC care systems. Findings provide baselines of system structures and insights into where resources are needed to fortify integration strategies. Results suggest that Central American countries have the building blocks in place to develop integrated care systems to meet the needs of people with dementia, but the links across service providers are opportunistic rather than context based coordinated integration policies.

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