Interventions into the care system for dementia

Abstract

Demographic developments contribute to an increasing proportion of elderly and age-associated diseases in industrialized countries worldwide. Dementia is one of the most prevalent in these. Dementia will cause growing support needs for the elderly and thus becomes a stability factor for the care system. Especially industrialized countries like North America, the EU or Asia need to prepare for this and develop strategies for their health care systems.

In Germany, there have been interventions into the care systems developed and implemented. This manuscript describes a selection of these. Firstly, we describe the AGNES study as an example of a successful translation from scientific evaluation into routine care. The AGNES study has shown positive results upon the delegation of medical tasks to specifically trained nurses and the model was introduced into the regular health care system on the federal level in Germany. Secondly we describe the DelpHi concept as dementia specific concept and study currently under evaluation. This study will yield results, how to deliver optimum care to persons with dementia and their caregivers in an efficient and effective way. And thirdly, we describe the IDemUck concept which shows measurable advantages on the management of dementia patients in an interdisciplinary network with respect to the provision of dementia-specific medication and the utilization of medical treatment.

On a policy level, the WHO stated co-ordination and care management as a clear goal in their dementia planning model. The international concepts are similar but the heterogeneity of integrated care models makes comparisons and translation into different contexts difficult. There is a further need to clearly describe aims and goals of concepts, describe the means to achieve these and prove their efficacy and efficiency. For an integration in routine care there is a need to adapt these concepts nationally and even regionally.