Meeting the Needs of the Growing Very Old Population: Policy Implications for a Global Challenge

Very old adults are one of the fastest-growing age groups worldwide. Yet they rarely constitute a targeted group for public policies. Drawing on the results of the centenarian studies presented in this special issue, we highlight major challenges that arise from the increase of this population. We outline several promising approaches for policy makers and professionals to develop evidence-based policies and programs that are tailored to the needs of very old adults and their families. We focus our discussion on three key topics essential to life care: the importance of integrated care to meet the complex care needs of the very old; the balance between formal and informal care; and the development of suitable places for living. Besides more specific measures, we propose that policies promoting the social integration of very old adults in their communities would be particularly helpful, as these may benefit not only the very old and ...

Community support programmes for people affected by dementia in Athens, Greece

The nonprofit organization AAADRD opened four day care centres across Athens to directly provide support services to people affected by dementia. The organization also campaigned extensively to gain attention for their cause and pushed the government to develop a national dementia action plan; highly motivated actors directly affected by dementia or working in related fields played an important role in identifying and understanding service delivery gaps; as a specialized organization, AAADRD was able to mobilize a large network of dedicated supporters. Connections established with similar organizations furthered advocacy efforts; sustainability of the initiative relies on growing government commitment, securing resources for activities and successfully implementing the national dementia action plan.

A model of integrated care of residents with dementia - A case of innovation in long-term with accomodation in Slovenia

In all parts of the world, the number of people with dementia is on the increase and dementia is becoming more and more of a challenge for social work, too. In the countries with well-developed care for older people, dementia is part of longterm care; therefore, it is essential to develop new methods of care also in the homes for older people that provide long-term care. Among the innovative forms of care, there is a model of integrated care, based on social work concepts. This model is presented through the case of care for the residents with dementia in one of the old people’s homes in Slovenia. The integrated care of residents with dementia puts an individual at the centre of care provided by the experts employed there. The resident of old people’s home and an expert there create a
partnership in which they seek out solutions stemming ...

Navigating COVID-19: Supporting Individuals With Dementia And Their Caregivers

The current COVID-19 emergency presents new and unique challenges for individuals diagnosed with Alzheimer’s disease and related dementia (ADRD) as well as the family and friends providing care for them.

Providers and health plans can play a key role in supporting individuals with ADRD and their caregivers as they navigate these challenges. This webinar provided information on how COVID-19 affects and presents in people with ADRD, strategies for family and friend caregivers for supporting those with ADRD living at home during COVID-19, and opportunities for health care systems to prepare to meet the needs of people with ADRD diagnosed with COVID-19.

• Freddi Segal-Gidan, PA, PhD; Director, USC-Rancho California Alzheimer’s Disease Center (CADC), Assistant Professor Clinical Neurology and Family Medicine, Keck School of Medicine of USC
• Joseph Herrera, MSW; Director, Outreach and Education, USC-Rancho CADC
• Jennifer Schlesinger, MPH, CHES; Director, Professional Training and Healthcare Services, Alzheimer’s ...

Empowering Better End-of-Life Dementia Care (EMBED-Care): A mixed methods protocol to achieve integrated person-centred care across settings

It is known that the number of people with dementia continues to increase in the world. We also know that people with dementia live to advanced stages of the disease, so they will require comprehensive palliative care. The aim objetive of this work, is to promote a “step change” in care for people with dementia and their carers to enable delivery of timely person-centred care, to identify unmet needs and improve outcomes, including comfort and qualitive of life, towards end of life. Each of six-interdependent work streams (WSs) will deliver new knowledge and sequentially build a complex intervention to improve palliative dementia care.

Use of Dementia Assessment Sheet for Community-based Integrated Care System 8-items (DASC-8) for the screening of frailty and components of comprehensive geriatric assessment

Comprehensive geriatric assessment (CGA)—a key tool for geriatric medicine—is commonly used to assess older people’s health status and frailty. However, performing CGA in outpatient clinics is difficult because the assessment of cognition, activities of daily living (ADLs), depression, quality of life (QoL), nutrition, medications and social conditions is time consuming and requires the cooperation of medical staff. Frailty—an aspect of geriatric medicine that indicates the weakness of the body—is a critical measure of older adults’ physical function.

The Dementia Assessment Sheet for Community-based Integrated Care System 8-items (DASC-8) is a validated and simple rating scale, developed for the classification of setting glycemic targets based on cognition and ADL for older adults with diabetes mellitus. As cognitive function and ADL are key elements of frailty in a broad sense and in CGA, we examined whether the DASC-8 category is useful for the ...

JICA Special Issue: Integrated Palliative and End of Life Care for People with Advanced Dementia or Frailty

This special issue now seems uncannily prescient in view of the devastating impact of COVID-19 on people with advanced dementia or severe frailty, particularly in care homes.

The pandemic has heightened awareness of the possibility of a sudden and rapid transition from relative health to a palliative or end of life stage. This has opened up conversations about the potential burden from intensive treatments that are likely to be futile and the benefits of advance care planning.

The collection of papers in this special issue will be of interest to readers involved in planning, commissioning or delivering palliative and end of life care services for our most vulnerable citizens at this time, whether at home or in a hospital, care home or hospice.

Read the full Guest Editorial and the collection of papers of this special issue

Person-Centred Care Transformation in a Nursing Home for Residents with Dementia

Conventional nursing homes in Singapore adopt an institutional and medical model of care with a focus on safety and risk management. As such, less regard is placed on upholding the dignity and autonomy of the resident, which compromises quality of care and the well-being of the resident. Today, person-centred care (PCC) has become synonymous with high-quality care that sustains the well-being and personhood of the care recipient.

How staff characteristics influence residential care facility staff’s attitude toward person-centered care and informal care

Staff members, and their attitudes, are crucial for providing person-centered care in residential care facilities for people with dementia. However, the literature on the attitudes of nursing staff regarding person-centered care is limited. The objective of this study is to explore the association between staff characteristics (age, education level, years of work experience and function, i.e., care or welfare) and staff attitudes toward perceived person-centered care provision and including informal caregivers in the caregiving process in residential care facilities.

What constitutes ‘good’ home care for people with dementia? An investigation of the views of home care service recipients and providers

Our objective was to explore what people receiving and providing care consider to be ‘good’ in-home care for people living with dementia.

Consensus was reached across all groups on five themes considered as important for good in-home dementia care: 1) Home care workers’ understanding of dementia and its impact; 2) Home care workers’ demonstrating person-centred care and empathy in their care relationship with their client; 3) Good relationships and communication between care worker, person with dementia and family carers; 4) Home care workers’ knowing positive practical strategies for changed behaviours; 5) Effective workplace policies and workforce culture. The results contributed to the co-design of a dementia specific training program for home care workers.

How to implement person-centred care and support for dementia in outpatient and home/community settings: Scoping review

Little prior research focused on person-centred care and support (PCCS) for dementia in home, community or outpatient care. We aimed to describe what constitutes PCCS, how to implement it, and considerations for women who comprise the majority of affected persons (with dementia, carers). Despite the paucity of research on PCCS for dementia, synthesis of knowledge from diverse studies into a Framework provides interim guidance for those planning or evaluating dementia services in outpatient, home or community settings. Further research is needed to elaborate the Framework, evaluate PCCS for dementia, explore determinants, and develop strategies to implement and scale-up PCCS approaches. Such studies should explore how to tailor PCCS needs and preferences based on input from persons with dementia, and by sex/gender and other intersectional factors such as ethnicity or culture.

Factors influencing the implementation of person-centred care in nursing homes by practice development champions: a qualitative process evaluation of a cluster-randomised controlled trial (EPCentCare) using Normalization Process Theory

Person-centred care (PCC) has been suggested as the preferred model of dementia care in all settings. The EPCentCare study showed that an adapted PCC approach was difficult to implement and had no effect on prescription of antipsychotics in nursing home residents in Germany. This paper reports the qualitative process evaluation to identify facilitators and barriers of the implementation of PCC in German nursing homes from the perspective of participating practice development champions.

Perceptions of people living with dementia regarding patient-centred aspects of their care and caregiver support

This study examined the perceptions of a sample of Australian people living with dementia regarding the person-centred care and support they received from health professionals and family.

Personalized Integrated Care Promoting Quality of Life for Older People: Protocol for a Multicenter Randomized Controlled Trial

Alzheimer disease (AD) and Parkinson disease (PD) are the 2 most common neurodegenerative diseases affecting millions of people worldwide. The Personalized Integrated Care Promoting Quality of Life for Older People (PC4L) project proposes an integrated, scalable, and interactive care ecosystem that can be easily adapted to the needs of several neurodegenerative and chronic diseases, care institutions, and end user requirements.

Improving the lives of people living with dementia