Dementia: innovative care approaches

In a nutshell: Due to demographic change, the number of people with dementia is expected to increase. Therefore, new approaches are needed to provide them with a familiar yet disease-adapted environment. In this context, the Memo Clinic® in Stralsund offers integrated care that ranges from outpatient to inpatient services. In addition, intelligent technologies are becoming more and more important as they can facilitate care and increase safety.


Background

The demographic change is reflected in an ongoing ageing of the population. In less than 15 years the number of people who are 65 or older will increase to more than 60 percent. As a result, in 2030 this age group will represent 12 percent of the world’s population (He et al. 2016, p. 3). Based on this development, more cases of dementia will occur, as age is the strongest and best-known risk factor for this disease (Alzheimer’s Society 2016, p. 4).

Dementia is an acquired brain syndrome characterized by a decline from a previous level of cognitive functioning with impairment in two or more cognitive domains [and] […] is not entirely attributable to normal aging.

WHO 2019

Importance of smart technology for people with dementia

At present, most elderly people desire to age at home because they want to remain in their community and maintain social contacts with friends and neighbours (Amárach Research et al. 2016, p. 6). However, if health problems emerge, a feeling of insecurity or reduced mobility is arising and the probability increases for elderly people that they will have to move to another accommodation, such as assisted living, caring homes and so forth (ibid, p. 37).

To delay this move as much as possible, smart technologies play an important role in the field of supporting security, autonomy and independent living. Interestingly, smart technologies can benefit and support not only the elderly but also people with dementia (Meiland 2017). They address disease-related symptoms and try to counteract them.

Thus, a dementia watch as well as an activity monitoring system can be helpful for memory problems and motion sensors or fall detectors for an increased risk of falling (Alzheimer’s Society, 2018). However, it should not be forgotten that many people with dementia are challenged by employing new applications (Evans et al. 2016, S. 7f).

Smart home system (Fung 2017)

One solution could be that in the near future municipalities and local communities are going to implement an authority responsible for providing technical support to elderly patients or relatives when they are in the need of it (Apfelbaum, Schatz, 2017). It is essential, however that intelligent and smart technologies are beneficial and supportive tools. Most important is that focus is laid on the patient and not on the technical gadget.

As a result, a combination of smart technologies and new approaches to treatment and accommodations is the best option for future care of people with dementia. Unfortunately, there is still a considerable need for action in the area of integrated care.

Perspectives shaping integrated care (Modified from Shaw et al. 2011, S. 13)
Perspectives shaping integrated care (Modified from Shaw et al. 2011, S. 13)

Memory Clinics as an example of successful integrated care for dementia

To close the gaps in nursing and care, the Uhlenhaus Group in Stralsund (Germany) has developed a new concept with the Memo® Clinic which is specialised in dementia care and is characterised by an intersectoral and interprofessional cooperation throughout the entire process of this disease.

Memory clinics are specialist services for assessing and diagnosing memory disorders in patients with early dementia

Segen’s Medical Dictionary 2012

The components of this concept are illustrated in the following figure:

The central elements of the Memo® Clinic (Modified from Richter et al. 2014, S. 88)
The central elements of the Memo® Clinic (Modified from Richter et al. 2014, S. 88)

This specialization and integrated care offer numerous advantages. Regular evaluations, development and implementation as well as collaborative agreements between the actors involved form the basis of the quality of care and collaboration. Once all services are available in one place, both patients and their relatives are able to have easier access to counselling, information and help.

Furthermore, the special design and the dementia-friendly building promote orientation and independence. In addition, the expertise of the involved partners and the transparency of each field of work can reduce the risk of competition and duplicate structures. Teamwork is also strengthened by the Care Centre Management. Due to case management, monitoring, person-centred practice and modularised service structure, a specifically tailored care-program is established to support the need for care.

It is also important to mention that the Memo® Clinic opens up to the community, on the one hand through offers such as exercise groups for people with or without dementia, and on the other hand through the geriatric practice. As a result, inhibition thresholds are reduced and awareness of this disease is raised.

The use of technology is applied here in the form of a digital patient file and a documentation system. These are going to support the flow of communication, smooth information and knowledge integration (Richter 2017, p. 8f).

Outlook

On the one side, people are getting older and the need of care becomes even more important (inclusive people with cognitive diseases), on the other side smart technologies are being developed extremely fast. The challenge for the future will be to combine caring and smart technologies in order to link up the process of caring to achieve the best well-being and quality of life for the human being.

In addition, smart technologies offer people with dementia a good chance to live longer independently and safely in their household. Furthermore, elderly people tend to accept smart technologies more readily, if those are already introduced during the healthy phase of their lives, so that they are accustomed to using them later on as well (Claßen et al. 2014, p. 98).

However, intelligent technologies are not sufficient for optimal care, especially for people with dementia. Hence, new opportunities in care must be looked for and the Memo® Clinic in Stralsund proves that integrated care is also possible for people with dementia. Even if the model of the Memo® Clinic is linked to conditions of the German healthcare system, suggestions and inspirations for other healthcare systems or countries can still be considered (Richter 2017, p. 2).

* This blog post was written in collaboration with Alisa Hemberger, Bachelor of health management (B.A.).


Further information

Literature

Amárach Research et al. (2016): Housing for older people – thinking ahead. PDF

Apfelbaum, B., Schatz, T. (2017): Digitalisierung des Alterns: Kompetent mitgestalten. Hochschule Harz. Präsentation am Techniksymposium Solingen, 01.12.2017.

Alzheimer’s Society (2016): Risk factors for dementia. PDF

Alzheimer’s Society (2018): Dementia-friendly technology – How dementia friendly technology could help you. Link

Claßen, K. et al. (2014): Umwelten des Alterns. Wohnen, Mobilität, Technik und Medien. Kohlhammer: Stuttgart.

Evans, D. et al. (2016): Home Alone With Dementia. In: Sage Open. 1-13.

Fung, P. (2017): Moving from centre based to home based interventions for people at early stage of dementia. URL: https://www.safeconcept.com.hk/en/2017-august-newsletter-moving-centre-based-home-based-interventions-people-early-stage-dementia/. (Accessed on 01/10/2019).

He, W. et al. (2016): International Population Reports, P95/16-1, An Aging World: 2015, U.S. Government Publishing Office, Washington, D. PDF

Meiland, F. et al. (2017): Technologies to Support Community-Dwelling Persons With Dementia: A Position Paper on Issues Regarding Development, Usability, Effectiveness and Cost-Effectiveness, Deployment, and Ethics. In: JMIR Rehabilitation and Assistive Technologies. 4 (1).

Richter, S. (2017): Integrated Care for People with Dementia – Results of a Social-Scientific Evaluation of an Established Dementia Care Model. In: Geriatrics. 2 (1).

Richter, S. et al. (2014): Integriert Versorgen bei Demenz – Gelingende Praxis am Beispiel der Memo Clinic®. SpringerMedizin: München.

Segen’s Medical Dictionary (2012): memory clinc. URL: https://medical-dictionary.thefreedictionary.com/memory+clinic. (Accessed on 02/10/2019).

Shaw, S. et al. (2011): What is integrated care? An overview of integrated care in NHS. Nuffield Trust. PDF

WHO, World Health Organization. (2019): ICD-11 for Mortality and Morbidity Statistics (Version: 04 / 2019). URL: https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/546689346. (Accessed on 02/10/2019).

Let’s discuss it!

  • What experiences have you had in caring for people with dementia?
  • What experiences have you had with technical assisted systems and ambient assisted living?
  • What are future caring innovations for people with dementia in inpatient and outpatient care?
  • How can supjective aspects and motives of happiness and life satisfaction of people with dementia be promoted in their daily lives, and how can an environment be created in which well-being is a primary goal?

Christian Heidl

Christian Heidl

Dr. Christian Heidl (MSc – Gesundheits- und Pflegewissenschaft, Diplom-Pflegewirt, Gesundheits- und Krankenpfleger) ist wissenschaftlicher Mitarbeiter und Lehrbeauftragter an der Wilhelm Löhe Hochschule in Fürth. Er lehrt im Bereich der Gerontologie und Gesundheitswissenschaften. Seine Arbeits- und Forschungsschwerpunkte umfassen die Digitalisierung der Pflege- und Gesundheitsversorgung, die Integrierte Forschung (ELSI) sowie Lebensqualitäts- und Zufriedenheitsforschung in pflegerischen und gerontologischen Versorgungskontexten. Nebenbei joggt er gerne und wandert in den Bergen.

Schreiben Sie einen Kommentar

Ihre E-Mail-Adresse wird nicht veröffentlicht. Erforderliche Felder sind mit * markiert.