Session Title: Alzheimer's Disease (AD) including Non-Cognitive Aspects
Presentation Date: Friday, March 14 – Saturday, March 15, 2009
MANAGEMENT OF PATIENTS WITH DEMENTIA: ASSESSMENT OF NON PHARMACOLOGIC INTERVENTIONS IN DAY-CARE HOSPITAL
I. Sors- Mireux1, F. Bonte2, B. Maakaroun1, L. Volpe-Gillot1
1Groupe Hospitalier Paris Saint Joseph, Centre Mémoire/Hopital de Jour, Paris, France, 2Groupe Hospitalier Paris Saint Joseph, Centre Mémoire/Hopital de Jour Psychogériatrique, Paris, France
The follow-up and management of patients and caregivers with dementia needs to be appropriate to each patient and family situation. Crisis may appear during years of follow up, unabled to be managed with just a few consultations.
The diagnosis announcement is a critical moment; non acceptance of professionnal help, by caregiver or patients; behavioural and psychological symptoms; burn-out of the caregiver; throughout the progression of the disease, are so many situations leading to conflicts and distress.
We would like to show in this study, the clinical way that conducts physicians to propose a specific day-care hospital support, during a memory consultation, when risk factors of crisis are identified.
A specific day care program is provided once or twice a week, during 6 months maximum. Non pharmacologic interventions as, reorientation therapy, reminiscence therapy, musicotherapy, psychomotricity and medical survey are proposed and exposed to the patient and his caregiver, in response of identified problems. We assessed the medico-psycho-social specific interventions after one month, and 6 months.
We experienced our model on almost 50 patients, in a retrospective study. We will now use it in a prospective study during 6 months.
The results obtained so far are showing a global benefit of this day-care hospital program, on specific items, such as behavioural and psychological symptoms of dementia, and quality of life, but not for all. The analysis of factors of success and failure will lead us to improve management of patients in the long term, and to propose alternative care when needed .