CareMENS : a new model of care for elderly at risk of dementia, applied in 7 swiss memory clinics

Abstract

AbstractBackgroundFourty percent of modifying factors explain cognitive decline in elderly, such as a lack of social and physical activities (Livingston 2020). Speech, physical and neuropsychological therapies have shown efficiency, although stopping them can have an impact on quality of life (Leidi, 2020). Therefore, usual models of care need to evolve to build bridges between therapies and community activities. The aim of CareMENS ( = Care, MEmory and NeuroScience), a new model, is to provide a continuity in patients’ care after the therapies, by assisting them to find a leisure activity in their community in order to stay active and socially involved (Annexe).SettingSeven Memory clinics in the french speaking part of Switzerland.Main outcome measuresQuality of life (WHOQOL), cognition (MoCA), severity of symptoms (CDR), autonomy in daily life activities (DAD‐6), anxiety and depression (HAD), satisfaction (self‐assessed questionnaire).MethodTo meet the needs of patients at risk of dementia and according to their symptomatology, they undergo speech, physical or neuropsychological therapy within a Memory clinic. Then, a care manager organize with the patient a leisure activity in the community to perpetuate the therapies’ benefice and to stay socially involved. Paired‐sample t‐tests were conducted between 2 measures: before therapy and after 3 months of leisure activity.ResultAmong 150 patients that started a therapy within CareMENS (Neuropsychology: n = 94, speech:n = 26, physical: n = 30), 100 completed their therapy, 61 already integrated a community activity and 31 ended the follow‐up. Results are reported for 25 patients. In a mean follow‐up time of 366 days, autonomy remained stable (p = 0.14), whereas global cognition decreased significantly (p = 0.01). Among anxious people, level of anxiety decreased significantly (p = 0.02). Global QOL was stable in patients (p = 0.15) and caregivers (p = 0.46), while the QOL’s dimension of “social participation” improved strongly and significantly in patients (p = 0.0001). Satisfaction to the care manager’s interventions and to the therapies were very encouraging (83.5%).ConclusionCareMENS is a new model of care that give a high satisfaction to patients and caregivers, improves the social dimension of quality of life and integrate patients in the society through community activities, that are enjoyable therefore sustainable.