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Background: People with dementia and their carers have a wide range of health and social care needs. People with dementia, carers and health and social care professionals (HSCPs) all have different perspectives on dementia care. Differences among these groups are important for commissioners of services and for front-line HSCPs. Objective: To compare the service recommendations of people with dementia and carers with those of HSCPs, under different budgetary conditions. Methods: A mixed-methods approach, which builds on the Balance of Care method, was used. Nine workshops were held with 41 participants from three groups: people with dementia, carers and HSCPs. Participants were asked to make decisions on a set of services for case types of dementia under two scenarios: a no budget constraint (NBC) scenario and a budget constraint (BC) scenario. Results: While each group allocated resources in broadly similar overall proportions, important differences in emphasis emerged: (i) people with dementia and carers placed more emphasis on psychosocial supports than HSCPs; (ii) carers put more emphasis on respite opportunities for carers; and (iii) carers identified residential care as the most suitable setting for the person with dementia more frequently than health care professionals. Conclusion: Our findings suggest that the importance of psychosocial interventions, including counselling and peer support programmes, are currently underestimated by HSCPs. The provision of in-home respite is highly valued by carers. Even with unconstrained resources, some carers do not judge home care to be a viable option for dementia case types with high-level care needs.

Additional file 1.

Additional file 1. Sample Vignette 4 ‘Mr Dunne’.

This audit is concerned with identifying the current provision of services and resources for people with dementia in Ireland. The audit is one part of a larger partnership study between the Centre for Economic and Social Research on Dementia and the Health Service Executive. The wider context for the audit is the National Dementia Strategy (NDS), which describes the need for integrated services and supports for people with dementia and action required to critically review health and personal social services for people with dementia to identify gaps in existing provision. Data on a range of services that are used by people with dementia in 2018 are collated in this report. The scope includes services directly provided by the HSE, services provided by voluntary organisations that are at least partly funded by the HSE and services that are contracted to private organisations (such as home support) that are fully funded by the HSE. Private or voluntary organisations or individuals that provide dementia-specific services but are not funded by the HSE were not included. Further detail on data sources, limitations and other notes associated with the highlights in this summary are to be found in the tables identified for each summary point.

The unemployment rate is a function of both the inflows to unemployment and the outflows from unemployment. Understanding the unemployment rate requires an understanding of the flows that drive the rate. This thesis contributes to the literature by using micro economic data to look carefully at a selection of factors that affect the heterogeneity of flows into and out of unemployment. In particular, I examine (i) how balance sheet factors affect decisions to reduce employment and other operating costs following a revenue shock; (ii) how unionisation affects redundancies and other involuntary job endings with particular attention to the interaction between unionisation and tenure; and (iii) how local labour demand conditions affects the duration of individual unemployment spells. I find that (i) the state of a firms balance sheet is not related to how it cuts employment numbers and operating costs; (ii) unionised firms have lower redundancy rates for low tenure employees; and (iii) unemployment durations are not affected by a lack of local labour demand.