title: Successful collaboration in dementia care from the perspectives of healthcare professionals and informal carers in Germany: results from a focus group study.
abstract: BACKGROUND
  Informal carers of persons with dementia are in contact with numerous healthcare professionals (HCP) in a complex healthcare system. Successful collaboration between the parties involved appears to be essential for good dementia care. Thus, we investigated the perceptions of both HCP and informal carers regarding successful collaboration and sought to describe obstacles and facilitators.
  
  
  METHODS
  As part of the 7(th) framework EU project RightTimePlaceCare, five focus groups were conducted with HCP and informal carers of persons with dementia in Germany (n = 30 participants/ time: Oct/Nov 2011). A supplementary secondary data analysis was performed, applying qualitative content analysis with open coding.
  
  
  RESULTS
  The derived categories were sorted into three overarching themes: collaboration between HCP and informal carers, collaboration among HCP and the impact of resources and healthcare system. HCP and informal carers largely agree on what facilitates or impedes successful collaboration between them. Making the initial contact appears to be a major challenge. While HCP expect to be contacted, informal carers hesitate to seek assistance, primarily due to inner barriers. Permanent contact person/institution, well-trained, empathetic HCP who can establish a trustful relationship are regarded as facilitating collaboration. The relational perspective is more clearly emphasised by HCP than by informal carers. This may be attributed to the absence of a permanent contact person in Germany. Sufficient information relay, clear responsibilities, motivation and defined aims, and a personal relationship between professionals are mentioned as facilitators. External factors, such as rapid staff turnover, insufficient time resources and conditions specified by the health and long-term care system causing financial competition between providers, are described as general barriers to successful collaboration.
  
  
  CONCLUSIONS
  HCP and informal carers had comparable perceptions of successful collaboration among them. The initial contact seems to be particularly challenging. Better strategies are urgently needed to facilitate the access to professional support. A permanent contact person (e.g., a case manager) might improve collaboration among all the parties involved, but this is not available regularly. Constraints created by the healthcare system may considerably hinder successful collaboration.
authors.affiliation: Faculty of Health, School of Nursing Science, Witten/Herdecke University, Stockumer Straße 12, 58453, Witten, Germany. astrid.stephan@uni-wh.de.|Medical Faculty, Institute for Health and Nursing Science, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany. astrid.stephan@uni-wh.de.
authors.forename: Astrid
authors.initials: A
authors.lastname: Stephan
authors.affiliation: Faculty of Health, School of Nursing Science, Witten/Herdecke University, Stockumer Straße 12, 58453, Witten, Germany. ralph.moehler@uni-wh.de.|Medical Faculty, Institute for Health and Nursing Science, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany. ralph.moehler@uni-wh.de.
authors.forename: Ralph
authors.initials: R
authors.lastname: Möhler
authors.affiliation: Faculty of Health, School of Nursing Science, Witten/Herdecke University, Stockumer Straße 12, 58453, Witten, Germany. anna.renom@uni-wh.de.|Faculty of Health, Institute of General Practice and Family Medicine, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58448, Witten, Germany. anna.renom@uni-wh.de.
authors.forename: Anna
authors.initials: A
authors.lastname: Renom-Guiteras
authors.affiliation: Faculty of Health, School of Nursing Science, Witten/Herdecke University, Stockumer Straße 12, 58453, Witten, Germany. gabriele.meyer@medizin.uni-halle.de.|Medical Faculty, Institute for Health and Nursing Science, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany. gabriele.meyer@medizin.uni-halle.de.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Meyer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D017028:Caregivers / Q000523:psychology*; D003299:Cooperative Behavior; D003704:Dementia / Q000451:nursing*; D005260:Female; D017144:Focus Groups; D005858:Germany; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008134:Long-Term Care; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged