Dementia care for people living at home in Norway. Dette er en side for grafer eller store illustrasjoner med evt header.

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1 Dementia care for people living at home in Norway November 24th, 2014 Kari Midtbø Kristiansen Executive manager Dette er en side for grafer eller store illustrasjoner med evt header. This is Norway 2"! 5 mill. people! 19 counties! 428 municipalities ( inhabitants)! > 50% 5000 inhabitants and this is also Norway 3" 4"! people (15%) # 65 years old! people (4,5%) 80 years old! persons with dementia! The Norwegian Government introduced the Norwegian national dementia plan in 2007 «Dementia Plan 2015»! (50%) living outside an institution! immediate family members affected " 5" 6" 1

2 ! «Active care» and day programs! Living facilities adapted to patients needs! Increased knowledge and skills! Assessment and diagnostics of people with dementia! The ABC model program! Educational programs, schools and support groups, for family caregivers! Program for Day activity! Young onset dementia! Non-pharmacological treatment 7" 8" 1. Assessment and diagnostics of people with dementia! Assist family doctors in diagnosing persons with symptoms that may indicate dementia! Follow up the patient and family carer through the course of the disorder Suitcase distributed to all Norwegian municipalities! Dementia teams are a part of the municipalities primary health care, paid for by tax money with no charge for the receiver 9" 10" Assessment - dementia Primary health care 65+ «Ordinary» Memory clinics and other specialist health care YOD Complicating factors Neuropsychiatric symptoms 11" Dementia team: Interview Observations Safety at home MMSE Clock Drawing Test IQCODE (change in cognition) ADL assessments Depression (Cornell) Family carer s burden (RSS) Family doctor: Physical examination Blood tests CT or MRI Diagnosis 12" 2

3 ! 2 or more experienced! Registered nurses! Occupational therapists! Other health care professionals! Cooperation with an assigned doctor is preferred 26 % of the teams in a survey had a doctor in their team! Easy for family doctors, community nursing service and families to contact the dementia team! Primary assessment in the patient s home, with patient and family carer present 13"! Information, motivate patients and carers to receive services Various day activity services Technical aids Home nurse! Provide guidance to patients and family carers Being available when needed! Help with practical problems Bills..! Update on functioning and need for services every 6 months! Re-testing every year 14"! Courses/ teaching for family carers and next of kin! Support/self-help groups! Teaching and supervision of other health care professionals in the municipalities! Contribute in planning dementia care in primary health care in the municipalities! Cooperation with other municipalities and with the specialist health care level 15"! At least one monthly visit by their contact from home care services, even though they don t yet have special needs! My history! Assess medication! Assess nutrition (weight)! Assess need for help to maintain personal hygiene! Assess walking, balance 16"! Assess home environment! Assess need for practical help, day care activity or other services! Assess need for assistive technology! An important goal is to prevent further problems and stop them before they escalate 17"! The red team in Hamar! The aim is to create security, continuity and trust for both patients and next of kin! Gives room for flexibility, the good moments, prevent crises, reduced absence among staff 18" 3

4 Make"a"new" assessment" Analyze" needs"and" give" guidance" Get"the"right" assis>ve" technology" No>ce" changes"in" need"" Make"sure"it" works"like" intended" Implement"it" It a jungle out there.. Work closely with the patient and the family 19" 20" 2. The ABC model ABC of care for people with dementia I. Educational material II. Multidisciplinary studygroups III. Seminars Educational program for staff 21" More than registered participants now in 392 Norwegian municipalities 22" 3. Educational programs for family care givers! This is what I need to know booklet and teaching plan for unskilled in health and caring! With the ABC program to be a health worker (50 students have got their licence now)! Vocational school in dementia and old age psychiatry! School for family carers! Support groups! To improve knowledge and awareness! To support family caregivers! To provide skills and knowledge on how to cope with the burden of care 23" 24" 4

5 3. Educational programs for family care givers Suitcase distributed to all schools for family carers! Many schools and support groups also open for people with dementia! Some of them run by voluntary organizations in cooperation with the local municipality! The schools get financial support from the authorities! 77 % of Norwegian municipalities offer a school for family carers, sometimes in cooperation with other municipalities near by Ageing and health is responsible for the project together with The Norwegian Health Association 25" 26"! Project to meet the needs of the Sami population, using video conference! Project to meet the needs of immigrants, with separate groups! Project to meet needs of next of kin to disabled people with dementia, with separate groups Weekend course for people with dementia under the age of 65 and a next of kin 27" 28" 4. Program for Day activity! Counselling, supervision and support to municipalities and organizations establishing day activity programs! Try to facilitate the variety in day care activities! There is financial support to establish this service Weekend course for youth, years old, with a mother or father with dementia 29" 30" 5

6 4. Program for Day activity Focus on:! Cultural and physical activities! Cognitive stimulation! Every day living activities! Well-being measures! Milieu therapy! Prevent/postpone institutionalization! Relief for families 31" 32" 5. Young onset dementia! This program provides special information about young onset dementia for patients, spouses, children and other! Young onset dementia is also a part of the other programs 6. Non-pharmacological treatment! The program spreads knowledge about person centred care and ways to implement and maintain person centred care for people with dementia! 4 different models:! Dementia Care Mapping! VIPS practice model! Marte Meo! Structured Milieu Therapy 33" 34" The national TV fundraiser Cooperation with different ideal organizations in different areas:! Day care activities! Educational programs for family caregivers The Norwegian Health Association is the special interest organization for people with dementia and their next of kin in Norway «No time to loose» They raised 229 mill NK 28 mill. 35" 36" 6

7 ! Research (40%)! Information! Activity friends! The 5 yearly National survey on services for people with dementia conducted in all Norwegian municipalities! The Norwegian guideline for dementia 37" 38" Ageing and health cooperate with The ministry of Health and Care services, The Directorate of Health and The Norwegian Health association in arranging dialogue meetings in 7 different cities before Christmas! A bit proud to work with the minister."! New government - new dementia plan: Dementia Plan 2020! Focus on the early and late states of dementia! People with dementia and their carers actively involved in the process Dialogue meeting with the minister of health in Oslo 39" 40" 7