Health and Social Care Professionals’ Experiences of Community-Based Dementia Care: A Qualitative Study of Needs, Barriers, and Ethical Challenges

Background: As the number of people living with dementia (PwD) rises, community care is increasingly prioritized to support aging in place. However, dementia care at home presents complex challenges, including unmet medical needs, family caregiver burdens, and ethical concerns.

Aim: This study aimed to explore healthcare professionals’ experiences and perceptions of community care for PwD, focusing on service delivery challenges, care needs, and ethical issues encountered in practice.

Methods: A qualitative descriptive design, following the Interpretive Phenomenological Approach, was used. Semi-structured interviews were conducted with 18 healthcare professionals providing community services, including doctors, nurses, and social workers. Data were analyzed thematically.

Results: Three main themes were identified: (1) Perceptions, differences, and gaps in service provision — professionals described varied understandings of dementia and highlighted inconsistencies in service coordination. Community care was often dependent on family initiative and limited by systemic barriers. (2) Dementia Patients’ Needs and Challenges: Participants emphasized the physical and psychosocial needs of PwD, including hygiene, nutrition, and wound care. Many families lacked the knowledge or resources to provide adequate care. Financial strain, caregiver fatigue, and cases of neglect or abuse were common. (3) Ethical Issues in Community Care: Challenges included misuse of care pensions, unsafe living environments, and conflicts concerning autonomy and consent.

Conclusion: Community care for PwD is shaped by complex clinical, social, and ethical dynamics. Strengthening caregiver education, improving supervision, and establishing formal ethical support systems are essential.

Keywords: Dementia, ethics, professionals, qualitative research