DESK REVIEWS | 07.02.01.06. Is there a mechanism to co-ordinate care, treatment, and support for people with dementia such as a care manager or dementia advisor, across health and long-term care?

DESK REVIEW | 07.02.01.06. Is there a mechanism to co-ordinate care, treatment, and support for people with dementia such as a care manager or dementia advisor, across health and long-term care?

Yes. The Dementia Community Support Scheme is a recently implemented mechanism to coordinate care across health and long-term care, which is launched by the Food and Health Bureau, the Social Welfare Department, and the Hospital Authority. It provides territory-wide support services to people with mild or moderate dementia and to their carers through a medical-social collaboration model (Social Welfare Department, 2020c). Advanced care nurses from Hospital Authority, nurses, social workers, occupational therapists and/or physiotherapists in District Elderly Community Centres work together to plan for inter-disciplinary care for people with dementia.

Besides, there is a Certi­fied Dementia Care Planner (CDCP) Course o­ffered by the Institute of Alzheimer’s Education of Hong Kong Alzheimer’s Disease Association, to train professional care planners who are equipped with comprehensive skills and knowledge about dementia care and can then provide continuity of care walking through the caring journey with families living with dementia, acting as coordinators with di­fferent dementia care teams in community, residential, and hospital settings (Hong Kong Alzheimer’s Disease Association, 2020a).

References:

Hong Kong Alzheimer’s Disease Association. (2020a). Certified Dementia Care Planner (CDCP) Course. Retrieved from http://ageing.hku.hk/upload/file/CDCP-8_flyer_new.pdf

Social Welfare Department. (2020c). Dementia Community Support Scheme. Retrieved from https://www.swd.gov.hk/dementiacampaign/en/info_5.html

There is not yet a regulation or mechanism from the government for this. We have learnt informally that ALZI is testing a new program called ‘Care Navigator’ which provides online support to family carers by referring them to relevant services, connecting them to experts who can help them address problems they are facing at home, such as behavioural and psychological symptoms of dementia (BPSD), combined with education sessions on dementia care skills.

These mechanisms do not exist in Jamaica.

See information systems for dementia – Part 6. Mental disorders are often reported as aggregate data rather than individual conditions (Kiarie et al., 2019), making it difficult to monitor conditions such as dementia.

References:

Kiarie, H., Gatheca, G., Ngicho, C., & Wangi, E. (2019). Lifestyle Diseases: An Increasing Cause of Health Loss. Nairobi, Kenya. https://www.health.go.ke/wp-content/uploads/2019/01/Revised-Non-Communicable-Disease-Policy-Brief.pdf

No mechanisms alike are available.

There is no formal system in NZ for care managers/dementia advisors to assist with the coordination of care, treatment, and support. While NASC agencies will coordinate funding and access to services, they don’t tend to get involved with the broader care and management. Some NGOs and local dementia organisations will fulfil this role, as will the MDT of those being managed under specialist services, but there is no formal system in place to facilitate navigation through the system.

These mechanisms (dementia advisor or dementia-care manager) do not exist formally within the public sector. Family practitioners (general practitioners/physicians) are largely the ‘first port of call’ for seeking care (Vally, 2010), and are usually within the private sector and act as case managers for care, treatment, and referral. There is currently no coordinated care, resource or planning mechanism across departments in government for persons with dementia in South Africa. Care coordination services and support for persons living with dementia rely on the NGO sector, which primarily provide support in terms of psychoeducation, training of carers, and linking service users to support groups in their areas.

References:

Vally, Z. (2010). The assessment and management of dementia. South African Family Practice, 52(5), 392–395. https://doi.org/10.1080/20786204.2010.10874014