Challenges in advanced dementia (original) (raw)

Appraising the need for care in alzheimer’s disease

BMC Psychiatry, 2013

Background Increasing incidences of dementia necessitate the improvement of supportive measures for patients suffering from this disease and their proxies. Clinicians without psychiatric backgrounds and others involved in appraising the supportive needs of dementia patients, such as those who allocate nursing insurance, base their appraisals on the ability of patients to perform basic and instrumental activities of daily living (B-ADL, iADL). Our aim was to investigate whether a reduced ability of the patient to perform ADL is sufficient to adequately assess the supportive needs of family caregivers. Methods Cross-sectional baseline data were obtained from dementia patients and their proxies in the context of a nationwide prospective cohort study on non-pharmacological treatment of dementia. To our knowledge, the present study is the first country-wide study to assess patients and proxies in their domestic surroundings (e.g. Mini-Mental State Examination (MMSE) Behave-AD, B-ADL and ...

Attending the unmet needs of Persons with dementia

As the prevalence of dementia continues to rise, it is imperative to address the unmet needs of individuals living with this condition. Meeting the unique needs of person with dementia requires a comprehensive understanding of the challenges they face, including cognitive decline, behavioral changes, and limitations in their everyday functioning. This paper reviews the current literature on the unmet needs of individuals with dementia and explores potential strategies to address these needs, including person-centered care, tailored interventions, caregiver support, and community engagement. By attending to the unmet needs of persons with dementia, healthcare professionals and policymakers can enhance quality of life and promote positive outcomes for both individuals and their caregivers. References: 1. Alzheimer's Association. (2021). 2021 Alzheimer's Disease Facts and Figures. Available at: https://www.alz.org/media/Documents/alzheimers-facts-and-figures.pdf 2. Brooker, D., & Latham, I. (2016). Person-centered dementia care: Making services better with the VIPS framework. Jessica Kingsley Publishers. 3. Hynes, S. M., Rousseau, N., & McGuire, B. E. (2018). Current knowledge, attitudes and practices of Irish clinicians in relation to the assessment of pain in dementia: protocol of a nationwide survey. BMJ open, 8(7), e020628. 4. Kahn, M., Ettema, T. P., & Savaskan, E. (2018). Cognitive decline in Alzheimer's disease: Impact on caregiver outcomes. Geriatrics, 3(4), 81. 5. Orrell, M., Hoe, J., Charlesworth, G., Russell, I., Challis, D., & Moniz-Cook, E. (2012). The needs of people with dementia in care homes: the perspectives of users, staff and family caregivers. International Psychogeriatrics, 24(7), 1172-1189. 6. Prince, M., Wimo, A., Guerchet, M., Ali, G. C., Wu, Y. T., & Prina, M. (2015). World Alzheimer Report 2015: The Global Impact of Dementia: An Analysis of Prevalence, Incidence, Cost and Trends. Available at: https://www.alz.co.uk/research/WorldAlzheimerReport2015.pdf

International reflections on caring for people with advanced dementia

Public Health Nursing

Almost 50 million people around the world are living with a dementia diagnosis and the number of new cases is increasing by about 7.7 million per year (World Health Organization, 2012). The condition affects mostly older people and has a long trajectory (Li et al., 2017; Verlinden et al., 2016). It starts off with the characteristic symptom of memory loss and ends with an inability to live daily life independently. Dementia has a huge impact on social, economic, and medical systems worldwide (World Health Organization, 2012). Many countries are attempting to address the challenge of dementia in their national strategies and action plans (Nakanishi et al., 2015; World Health Organization, 2012). Although the approaches within these national plans and strategies vary from country to country, reflecting different social structures and policy situations, the worldwide priority actions are agreed to be awareness raising and prevention; early diagnosis; commitment to good quality continuing care and services; caregiver support; workforce planning and effective training; research to better understand the disease and inform evidence-based care (World Health Organization, 2012). Dementia is recognized as a long-term life-limiting illness: as yet there is no cure or effective treatment (Koller et al., 2012; Lee & Chodosh, 2009). With such a lengthy deterioration, patients often develop comorbidities and at the same time, lose the

The worldwide costs of dementia 2015 and comparisons with 2010

Alzheimer's & dementia : the journal of the Alzheimer's Association, 2016

In 2010, Alzheimer's Disease International presented estimates of the global cost of illness (COI) of dementia. Since then, new studies have been conducted, and the number of people with dementia has increased. Here, we present an update of the global cost estimates. This is a societal, prevalence-based global COI study. The worldwide costs of dementia were estimated at United States (US) 818billionin2015,anincreaseof35818 billion in 2015, an increase of 35% since 2010; 86% of the costs occur in high-income countries. Costs of informal care and the direct costs of social care still contribute similar proportions of total costs, whereas the costs in the medical sector are much lower. The threshold of US 818billionin2015,anincreaseof351 trillion will be crossed by 2018. Worldwide costs of dementia are enormous and still inequitably distributed. The increase in costs arises from increases in numbers of people with dementia and in increases in per person costs.

An estimate of the total worldwide societal costs of dementia in 2005

Alzheimer's & Dementia, 2007

Background: The aim of this report was to estimate the worldwide cost of dementia in 2005 from a societal viewpoint. Methods: Costs were estimated by combining prevalence estimates, country and region specific data on Gross Domestic Product per person, and average wage with results from previously published cost-of-illness studies in different countries. Direct medical and nonmedical costs as well as costs for informal care were included. Results: The total worldwide societal cost of dementia, on the basis of a dementia population of 29.3 million persons, was estimated to be US$315.4 billion in 2005, including US$105 billion for informal care (33%). Seventy-seven percent of the total costs occurred in the more developed regions, with 46% of the prevalence. Conclusions: Worldwide costs for dementia are enormous, and informal care constitutes a major cost component, in particular in less developed regions. The health economics of dementia is a highly relevant area for further research.

The worldwide societal costs of dementia: Estimates for 2009

Alzheimer's & Dementia, 2010

Background: The purpose of this study was to update the previous estimate of the worldwide cost of dementia in 2005 to 2009. Methods: The cost model is based on prevalence estimates, country and region-specific data on Gross Domestic Product per person and average wage, with results from previously published cost-of-illness studies in different countries. Prevalence figures are updated to 2009 and costs were adjusted to 2009 constant US dollars ($). Results: The total worldwide societal cost of dementia, based on a dementia population of 34.4 million demented persons, was estimated to 422billionin2009,including422 billion in 2009, including 422billionin2009,including142 billion for informal care (34%). Conclusions: The worldwide cost of dementia has increased by 34% (18% in fixed prices) between 2005 and 2009.