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Symposium S2: Facing dementia together - Professional carers & people with dementia and their carers

Detailed Programme and abstracts

Friday, 1 October 2010: 16.00-17.30 (Red Room)

S2.1. Care approaches in Eastern European countries

Iva Holmerová, Czech Alzheimer Society, Czech Republic,

Countries of Central and Eastern Europe, including the Czech Republic, have for many decades been part of a different system i.e. different from the other parts of Europe. These states were called socialist or people´s states but many policies were not of and for the people. It is now more than 20 years since the political changes that opened the way for our countries to reintegrate into Europe.

Some countries of the former socialist block, including the Czech Republic, became members of the European Union. Reforms of health care systems are different in different countries but in all of them, the level of acute medical care has improved. Also, systems of social care have changed and many innovative services have been introduced. There are important diferences between EU countries and important common features of their development.

The number of people with dementia is rapidly increasing. However, health and social care systems often do not respond adequately either to their needs or to needs of their caregivers. There are many systemic and local obstacles to the provision of care, including both health and social care. However, there are also many innovative practices aimed at improving care. In general, EU governments should improve the care of the chronically sick, including people with dementia and develop their systems of community care. National Alzheimer´s disease strategies should play a leading role in this development.

S2.2. A rehabilitative approach to dementia care

Kaisu Pitkälä, University of Helsinki and Helsinki University Central Hospital. Finland.

Dementia and Alzheimer’s disease (AD) have harmful consequences on patients’ cognitive and physical functioning. AD patients suffer often from physical symptoms such as weight loss, as well as behavioural and psychological symptoms (BPSD). AD is a disease of the whole family affecting caregiver’s quality-of-life, burden, stress, and economical situation. Thus, the targets of dementia rehabilitation are multiple. Even in case of dementia rehabilitation may be preventive, maintaining or restoring.

There are several trials showing evidence that physical exercise, cognitive training and socially activating group rehabilitation have favorable effects on older people’s cognitive functioning. Thus, they may have preventive effects on dementia. Among patients with dementia physical exercise may have favorable effects on behavioural and psychological symptoms of dementia (BPSD), especially on depression, on patients’ cognition and caregivers’ quality of life (QOL). Physical exercise has effectiveness also on mobility and physical functioning. The exercise programme should be intensive and long-lasting to show its effectiveness on functioning. However, most of these trials investigating the effects of physical exercise on dementia patients have been conducted among institutionalised older people. Thus, the target group is not purely dementia patients. In addition, we do not know whether physical exercise postpones institutional care among home-dwelling patients with dementia.

The most consistent and strongest evidence of effectiveness of rehabilitative approach in dementia is the comprehensive care of a case manager. There are randomised trials from several countries and contexts showing that using an expert in dementia care and in service system as a case manager postpones institutional care of dementia patients and improves caregivers’ QOL. The elements of effective case manager care include family-centered approach, resource oriented work, coordinated care with tailored treatments, and often geriatricians’ involvement. The case manager should have good communication skills with ability to support caregivers’ self-management and problem-solving skills and autonomy of the families.

The evidence-base of rehabilitative approach to dementia care will be opened up in this presentation.

S2.3. End-of-life care for people with dementia – an evaluation of two innovative approaches in Luxembourg

Christina Kuhn, M.A., Demenz Support Stuttgart gGmbH,Germany,

Due to impairments both in terms of mobility and verbal skills, people in far advanced stages of dementia may heavily depend on others for their well-being. So-called oases are care settings designed for this particular group of persons and predominatly occupied by them. In such an oasis, the physical presence of one staff member is warranted throughout the day. This enables formal carers to immediately respond to inhabitants’ needs, adjust the tasks of caring to the cared-for person’s rhythm and support adequate symptom control and symptom abatement. In the context of daily care, oasis inhabitants are regularly supplied with sensory stimulation. Demenz Support Stuttgart has carried out an evaluation of two care oases in Luxembourg. This presentation provides an overview of the study results and discusses the preconditions and constraints tied to this new care setting’s successful implementation.

S2.4. Ethical implications of assistive technologies in care settings

Dianne Gove, Alzheimer Europe, Luxembourg,

Dianne Gove will talk about the ethical issues linked to the use of assistive technology in residential care settings based on the work of the working group on assistive technology which was set up in the framework of the Dementia Ethics Network.

First, she will briefly explain what assistive technology is and provide background information on ethics and the main ethical principles which were considered in relation to the ethical use of assistive technologies for people with dementia in residential care.

She will then concentrate on ethical issues linked to the use of tracking and surveillance devices or systems and those linked to the use of assistive technologies in the context of recreation, interaction and well-being, expanding on several issues such as autonomy, freedom, safety, stigmatization, dignity and privacy, as well as considering some of the ethical issues faced by healthcare professionals.



Last Updated: Wednesday 03 November 2010