Verena Leve

„Aging Brain Care Program“ aus Indianapolis

BACKGROUND New and innovative concepts of care management have been developed to improve the health of older adults with dementia and depression. AIM This article describes the American aging brain care (ABC) program and the possible transfer to the German healthcare system is discussed. MATERIAL AND METHODS The ABC medical home model in Indianapolis incorporates a specialized geriatric healthcare center which is affiliated to the Eskenazi Hospital as well as a program involving home-based domestic visits by healthcare personnel to affected people. The diagnoses are made in the geriatric center where therapy and treatment are also planned. These stages are carried out in a multiprofessional team, which identifies the individual needs of the patients and relatives and discusses these in family conferences as well as in close consultation with the primary care center of the hospital. The care, diagnosis and therapy are coordinated using a self-developed software for the program and via predetermined pathways and procedural instructions on the approach in the healthcare center and in the domestic visit program. RESULTS AND CONCLUSION From the perspective of the authors the core elements of the program include not only the use of a home-based care model but also the selection and training of a new type of front-line care provider. Models like the program presented here show great promise for meeting the demands of a rapidly expanding population of vulnerable older adults.ZusammenfassungHintergrundDie angemessene Versorgung von älteren Menschen mit Demenz und/oder Depression verlangt nach innovativen Konzepten.Ziel der ArbeitIm vorliegenden Beitrag wird das US-amerikanische Aging Brain Care (ABC) Program beschrieben und eine mögliche Übertragbarkeit auf den deutschen Versorgungskontext diskutiert.Material und MethodenDas „ABC Medical Home Model“ in Indianapolis umfasst sowohl ein geriatrisch-spezialisiertes Versorgungszentrum, das an das Eskenazi Hospital angeschlossen ist, als auch ein Programm, in dem Mitarbeiter die betroffenen Menschen in ihrer Häuslichkeit aufsuchen. Im geriatrischen Zentrum werden die Diagnosen gestellt sowie Therapien und Versorgung geplant. Dies geschieht im multiprofessionellen Team, das die individuellen Hilfebedarfe der Patienten und ihrer Angehörigen ermittelt und diese in „family conferences“ bespricht, sowie in enger Abstimmung mit dem „Primary Care Center“ des Hospitals. Über eine eigens für das Programm entwickelte Software sowie über festgelegte Abläufe bzw. Handlungsanweisungen für das Vorgehen im Versorgungszentrum und im Hausbesuchsprogramm werden die Betreuung, Diagnosestellung und Therapie gesteuert.Ergebnisse und SchlussfolgerungAus Sicht der Autoren scheinen insbesondere die Strukturierung der Versorgung aus einer Hand sowie die Qualifikation und die Qualifizierung der Beteiligten Kernelemente des ABC-Programms zu sein. Modelle wie das hier vorgestellte Programm sind vielversprechend, um den Herausforderungen einer alternden Bevölkerung begegnen zu können.AbstractBackgroundNew and innovative concepts of care management have been developed to improve the health of older adults with dementia and depression.AimThis article describes the American aging brain care (ABC) program and the possible transfer to the German healthcare system is discussed.Material and methodsThe ABC medical home model in Indianapolis incorporates a specialized geriatric heathcare center which is affiliated to the Eskenazi Hospital as well as a program involving home-based domestic visits by healthcare personnel to affected people. The diagnoses are made in the geriatric center where therapy and treatment are also planned. These stages are carried out in a multiprofessional team, which identifies the individual needs of the patients and relatives and discusses these in family conferences as well as in close consultation with the primary care center of the hospital. The care, diagnosis and therapy are coordinated using a self-developed software for the program and via predetermined pathways and procedural intructions on the approach in the healthcare center and in the domestic visit program.Results and conclusionFrom the perspective of the authors the core elements of the program include not only the use of a home-based care model but also the selection and training of a new type of front-line care provider. Models like the program presented here show great promise for meeting the demands of a rapidly expanding population of vulnerable older adults.

„Aging Brain Care Program“ aus Indianapolis@@@Aging Brain Care Program from Indianapolis: Übertragbarkeit auf den deutschen Versorgungskontext@@@Transferability to the German healthcare system

BACKGROUND New and innovative concepts of care management have been developed to improve the health of older adults with dementia and depression. AIM This article describes the American aging brain care (ABC) program and the possible transfer to the German healthcare system is discussed. MATERIAL AND METHODS The ABC medical home model in Indianapolis incorporates a specialized geriatric healthcare center which is affiliated to the Eskenazi Hospital as well as a program involving home-based domestic visits by healthcare personnel to affected people. The diagnoses are made in the geriatric center where therapy and treatment are also planned. These stages are carried out in a multiprofessional team, which identifies the individual needs of the patients and relatives and discusses these in family conferences as well as in close consultation with the primary care center of the hospital. The care, diagnosis and therapy are coordinated using a self-developed software for the program and via predetermined pathways and procedural instructions on the approach in the healthcare center and in the domestic visit program. RESULTS AND CONCLUSION From the perspective of the authors the core elements of the program include not only the use of a home-based care model but also the selection and training of a new type of front-line care provider. Models like the program presented here show great promise for meeting the demands of a rapidly expanding population of vulnerable older adults.ZusammenfassungHintergrundDie angemessene Versorgung von älteren Menschen mit Demenz und/oder Depression verlangt nach innovativen Konzepten.Ziel der ArbeitIm vorliegenden Beitrag wird das US-amerikanische Aging Brain Care (ABC) Program beschrieben und eine mögliche Übertragbarkeit auf den deutschen Versorgungskontext diskutiert.Material und MethodenDas „ABC Medical Home Model“ in Indianapolis umfasst sowohl ein geriatrisch-spezialisiertes Versorgungszentrum, das an das Eskenazi Hospital angeschlossen ist, als auch ein Programm, in dem Mitarbeiter die betroffenen Menschen in ihrer Häuslichkeit aufsuchen. Im geriatrischen Zentrum werden die Diagnosen gestellt sowie Therapien und Versorgung geplant. Dies geschieht im multiprofessionellen Team, das die individuellen Hilfebedarfe der Patienten und ihrer Angehörigen ermittelt und diese in „family conferences“ bespricht, sowie in enger Abstimmung mit dem „Primary Care Center“ des Hospitals. Über eine eigens für das Programm entwickelte Software sowie über festgelegte Abläufe bzw. Handlungsanweisungen für das Vorgehen im Versorgungszentrum und im Hausbesuchsprogramm werden die Betreuung, Diagnosestellung und Therapie gesteuert.Ergebnisse und SchlussfolgerungAus Sicht der Autoren scheinen insbesondere die Strukturierung der Versorgung aus einer Hand sowie die Qualifikation und die Qualifizierung der Beteiligten Kernelemente des ABC-Programms zu sein. Modelle wie das hier vorgestellte Programm sind vielversprechend, um den Herausforderungen einer alternden Bevölkerung begegnen zu können.AbstractBackgroundNew and innovative concepts of care management have been developed to improve the health of older adults with dementia and depression.AimThis article describes the American aging brain care (ABC) program and the possible transfer to the German healthcare system is discussed.Material and methodsThe ABC medical home model in Indianapolis incorporates a specialized geriatric heathcare center which is affiliated to the Eskenazi Hospital as well as a program involving home-based domestic visits by healthcare personnel to affected people. The diagnoses are made in the geriatric center where therapy and treatment are also planned. These stages are carried out in a multiprofessional team, which identifies the individual needs of the patients and relatives and discusses these in family conferences as well as in close consultation with the primary care center of the hospital. The care, diagnosis and therapy are coordinated using a self-developed software for the program and via predetermined pathways and procedural intructions on the approach in the healthcare center and in the domestic visit program.Results and conclusionFrom the perspective of the authors the core elements of the program include not only the use of a home-based care model but also the selection and training of a new type of front-line care provider. Models like the program presented here show great promise for meeting the demands of a rapidly expanding population of vulnerable older adults.

„Aging Brain Care Program“ aus Indianapolis: Übertragbarkeit auf den deutschen Versorgungskontext

BACKGROUND New and innovative concepts of care management have been developed to improve the health of older adults with dementia and depression. AIM This article describes the American aging brain care (ABC) program and the possible transfer to the German healthcare system is discussed. MATERIAL AND METHODS The ABC medical home model in Indianapolis incorporates a specialized geriatric healthcare center which is affiliated to the Eskenazi Hospital as well as a program involving home-based domestic visits by healthcare personnel to affected people. The diagnoses are made in the geriatric center where therapy and treatment are also planned. These stages are carried out in a multiprofessional team, which identifies the individual needs of the patients and relatives and discusses these in family conferences as well as in close consultation with the primary care center of the hospital. The care, diagnosis and therapy are coordinated using a self-developed software for the program and via predetermined pathways and procedural instructions on the approach in the healthcare center and in the domestic visit program. RESULTS AND CONCLUSION From the perspective of the authors the core elements of the program include not only the use of a home-based care model but also the selection and training of a new type of front-line care provider. Models like the program presented here show great promise for meeting the demands of a rapidly expanding population of vulnerable older adults.ZusammenfassungHintergrundDie angemessene Versorgung von älteren Menschen mit Demenz und/oder Depression verlangt nach innovativen Konzepten.Ziel der ArbeitIm vorliegenden Beitrag wird das US-amerikanische Aging Brain Care (ABC) Program beschrieben und eine mögliche Übertragbarkeit auf den deutschen Versorgungskontext diskutiert.Material und MethodenDas „ABC Medical Home Model“ in Indianapolis umfasst sowohl ein geriatrisch-spezialisiertes Versorgungszentrum, das an das Eskenazi Hospital angeschlossen ist, als auch ein Programm, in dem Mitarbeiter die betroffenen Menschen in ihrer Häuslichkeit aufsuchen. Im geriatrischen Zentrum werden die Diagnosen gestellt sowie Therapien und Versorgung geplant. Dies geschieht im multiprofessionellen Team, das die individuellen Hilfebedarfe der Patienten und ihrer Angehörigen ermittelt und diese in „family conferences“ bespricht, sowie in enger Abstimmung mit dem „Primary Care Center“ des Hospitals. Über eine eigens für das Programm entwickelte Software sowie über festgelegte Abläufe bzw. Handlungsanweisungen für das Vorgehen im Versorgungszentrum und im Hausbesuchsprogramm werden die Betreuung, Diagnosestellung und Therapie gesteuert.Ergebnisse und SchlussfolgerungAus Sicht der Autoren scheinen insbesondere die Strukturierung der Versorgung aus einer Hand sowie die Qualifikation und die Qualifizierung der Beteiligten Kernelemente des ABC-Programms zu sein. Modelle wie das hier vorgestellte Programm sind vielversprechend, um den Herausforderungen einer alternden Bevölkerung begegnen zu können.AbstractBackgroundNew and innovative concepts of care management have been developed to improve the health of older adults with dementia and depression.AimThis article describes the American aging brain care (ABC) program and the possible transfer to the German healthcare system is discussed.Material and methodsThe ABC medical home model in Indianapolis incorporates a specialized geriatric heathcare center which is affiliated to the Eskenazi Hospital as well as a program involving home-based domestic visits by healthcare personnel to affected people. The diagnoses are made in the geriatric center where therapy and treatment are also planned. These stages are carried out in a multiprofessional team, which identifies the individual needs of the patients and relatives and discusses these in family conferences as well as in close consultation with the primary care center of the hospital. The care, diagnosis and therapy are coordinated using a self-developed software for the program and via predetermined pathways and procedural intructions on the approach in the healthcare center and in the domestic visit program.Results and conclusionFrom the perspective of the authors the core elements of the program include not only the use of a home-based care model but also the selection and training of a new type of front-line care provider. Models like the program presented here show great promise for meeting the demands of a rapidly expanding population of vulnerable older adults.

INTERVENTIONS TO IMPROVE PRIMARY DEMENTIA CARE

tia. Methods:Semi-structured interviews were carried out with 14 spouses of partners with dementia. The interviews included the completion of the NPI (Neuropsychiatric Inventory, Cummings, 1994). Interview data was analysed using content analysis. Results:(Preliminary) Spouses identified that partners with dementia had on average five to eight co-existing NPI symptoms. Frequency, severity and distress varied. The behavioural and psychological symptoms highlighted were within three of four possible symptom domains; Behaviour, Psychosis and Mood. From the narrative data four main categories emerged; Support, Coping, Vulnerability and domestic violence AND Social isolation. Conclusions:A large proportion of persons with dementia reside in the community. Support offered to persons with dementia and their families should have a person-centered approach meeting individual needs. A greater awareness is required regarding welfare and safety of persons with dementia and their partners in a community setting.

Innovative health care models for persons with dementia: A comparison of our german and american experiences

to have their memory evaluated, actual screening behaviors were more likely to occur in individuals with high self-efficacy for discussing memory problems, perceived accessibility to dementia services, already present preventive health behaviors, and a social support system. These constructs can be used to develop interventions to evaluate and improve cognitive health in African Americans.

A PEER-TO-PEER INTERVENTION TO CHANGE ATTITUDES OF FAMILY PHYSICIANS TOWARD DEMENTIA

diagnosis; or delayed access to the next step in the diagnostic process.While research is ongoing, there is evidence to support the usefulness of a timely diagnosis of dementia. This project is specifically interested in local and international examples of service models which focus on reducing the time lag to diagnosis. Methods: A review of the international literature, including grey literature, was conducted. Contact was made with service providers identified as carrying out relevant activities, even if associated health service research had not already been completed for these activities. Results: Following a search of computerised databases, 34 relevant papers were identified. This was supplemented with some interviews to capture as yet unpublished new service models. A diverse range of countries were identified including: England, Netherlands, America, and Australia Models included: the creation of specialised centres such as memory clinics; use of individual specialists (i.e. psychiatrists, neurologists); multiple component interventions linked to clinical care pathways); practice nursing staff; telehealth. There are key recommendations for the implementation of strategies relevant for Australia and research gaps in relation to knowledge translation (i.e. what additional evidence is required to show the effectiveness of existing implementation strategies). Conclusions: Early/timely diagnosis of dementia is often overlooked as an opportunity for change, given the challenges associated with prevention, treatment and/or cure. This project articulates the potential for translating existing evidence for the task of early/timely diagnosis into clinical practice.

Changing attitudes toward dementia in family practice

Horst Christian Vollmar, Verena Leve, Jacqueline Verena Michel, StefanWilm, Michael Pentzek, Department of General Practice, Faculty of Medicine, Heinrich-Heine-University Duesseldorf, D€usseldorf, Germany; Faculty of Medicine, Heinrich-Heine University Duesseldorf, D€usseldorf, Germany; Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands; Faculty of Medicine, Heinrich-Heine University Duesseldorf, D€usseldorf, Germany; Faculty of Medicine, Heinrich-Heine University Duesseldorf, D€usseldorf, Germany. Contact e-mail: hcvollmar@web.de