Experiences of nurse practitioners delivering dementia care in rural and remote communities in Canada and Australia: an integrative review

Abstract

Background: Nurse practitioners (NP) delivering primary care for dementia patients in rural and remote regions face numerous challenges. These challenges are characterized by a lack of resources, integration difficulties, and limited scope of practice, which complicate recruitment and retention efforts. With increasing prevalence of dementia in these regions, advanced dementia care services are needed for health equity. Purpose: This study explores nurse practitioners' experiences in providing dementia care in rural and remote communities in Canada and Australia. It provides actionable recommendations to improve the delivery of dementia care to underserved populations. Method: Whittmore and Knafl's (2005) integrative review methodology guided this research. The approach enables the incorporation of various study designs and guided synthesis, adding method and rigour to the analysis of the existing literature. Bronfenbrenner's (1979) social- ecological model was employed as the conceptual framework to identify the systems that impact NP-led dementia care in rural and remote communities. Results: Nurse practitioners significantly contribute to primary dementia care by filling critical gaps in health services. However, systematic barriers, such as resource shortages and policy limitations, hinder care. The role of the NP in these settings emphasizes the importance of interprofessional collaboration between practice nurses, physicians, and NPs and the need to optimize education and policy support. Conclusion: This review recommends improving NP-led dementia care in rural and remote regions by addressing systematic challenges, enhancing education and training, and informing healthcare policies.