scholarly journals THE PRICE OF DEMENTIA: POLICY STRATEGIES TO NARROW HEALTH DISPARITY GAPS, REDUCE COSTS, AND IMPROVE QUALITY OF LIFE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S451-S451
Author(s):  
Nora Super ◽  
Rajiv Ahuja ◽  
Kevin Proff
Keyword(s):  
Quality Of Life ◽  
Current System ◽  
Caregiver Training ◽  
Policy Recommendations ◽  
Improve Quality ◽  
Cognitive Screening ◽  
Brain Health ◽  
Community Based Interventions ◽  
Community Based

Abstract Historically, a diagnosis of Alzheimer’s disease and related dementias (ADRDs) created a sense of hopelessness among those diagnosed, their families, and physicians. The misperception that there is no available medical treatment or interventions inhibited patients from receiving cognitive assessments or exploring home- and community-based interventions that could improve quality of life. Today, researchers have developed evidence-based pathways to improve brain health, reduce dementia risk, and enhance lifelong cognitive function. This report highlights recent scientific advancements focused on medical and lifestyle interventions that reduce the risk of ADRDs and slow the disease progression. To improve the current system and reduce the risk of dementia and improve brain health, the following policy areas are recommended: 1) promote brain health strategies to delay onset and reduce the stigma associated with cognitive decline; 2) increase early detection and cognitive screening efforts; 3) build a dementia-capable workforce; 4) create seamless transitions from health systems to community-based services to better support those with dementia; 5) improve caregiver training and support; and 6) increase funding for research related to ADRDs. Understanding that ADRDs disproportionately impact certain populations, these policy recommendations include strategies to narrow health disparities. Previous Milken Institute research highlighted the disproportionate health impacts of dementia on women, which costs the economy trillions of dollars. This report expands on that analyses and stratifies the data by race and income as well. Ensuring that these policy recommendations address disproportionately impacted groups will benefit the broader healthcare system and alleviate the burden felt by all patients and families.

scholarly journals Developing a community-based intervention to improve quality of life in people with colorectal cancer: a complex intervention development study

BMJ Open ◽  
2013 ◽  
Vol 3 (4) ◽  
pp. e002596 ◽  
Author(s):  
Nicola M Gray ◽  
Julia L Allan ◽  
Peter Murchie ◽  
Susan Browne ◽  
Susan Hall ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Colorectal Cancer ◽  
Complex Intervention ◽  
Intervention Development ◽  
Improve Quality ◽  
Community Based ◽  
Development Study

Potential for Community Relocation among Residents of Alberta's Psychiatric Facilities: A Needs Assessment

1997 ◽  
Vol 42 (7) ◽  
pp. 750-757 ◽  
Author(s):  
Heather L Holley ◽  
Betty Jeffers ◽  
Phyllis Hodges
Keyword(s):  
Quality Of Life ◽  
Substance Abuse ◽  
Forensic Psychiatry ◽  
Psychiatric Hospitals ◽  
Mental Illnesses ◽  
Improve Quality ◽  
Short Term ◽  
Community Based ◽  
Institutionalized Patients

Objective: To identify the proportion of residents in Alberta's psychiatric hospitals who would be relocatable to community-based alternatives to care if appropriate programs were made available. Methods: A survey of a representative sample of residents in all psychiatric hospitals and care centres was undertaken, excluding patients in specialized programs for forensic psychiatry, brain injury, and substance abuse. Results: Findings indicate that 11% of institutionalized patients could be considered good candidates for relocation to community-based alternative care. A further 35% were considered to have potential for relocation provided an intensive and complex array of services was first made available. Conclusion: Results support a phased-in approach to hospital downsizing and the need for considerable transitional funding. Because hospital downsizing is unlikely to save dollars, at least in the short term, reforms must remain guided by humanitarian motivations to improve quality of life for persons with severe and persistent mental illnesses.

A Systematic Review of the Efficacy of Community-based, Leisure/Social Activity Programmes for People with Traumatic Brain Injury

2014 ◽  
Vol 15 (3) ◽  
pp. 157-176 ◽  
Author(s):  
Robyn Tate ◽  
Donna Wakim ◽  
Michelle Genders
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Single Case ◽  
Social Activity ◽  
Controlled Trials ◽  
Community Based Interventions ◽  
Community Based ◽  
Meaningful Activity ◽  
Active Leisure

Background: Many people who have a severe traumatic brain injury (TBI) are not able to resume employment and consequently experience profound changes in their lifestyle. They have increased amounts of ’spare time’ yet often find it difficult to engage in meaningful activity. Leisure activities are one way in which meaningful activity can be increased.Aims: This systematic review has two purposes: first, to identify and evaluate the efficacy of community-based interventions for leisure/social activity after TBI, and second to provide details on the types of intervention.Method: Systematic searches were conducted of Medline, PsycINFO and PsycBITE to October 2014, as well as hand searches of two occupational therapy journals. Inclusion criteria were as follows: peer reviewed journal articles on adults with TBI who had participated in a trial evaluating a community-based intervention specifically targeting leisure/social activity. All research methodologies using primary studies that provided empirical, quantitative data were considered. Scientific quality of the studies was evaluated using the PEDro Scale for controlled trials and the Risk of Bias in N-of-1 Trials Scale for single-case designs.Results: Two independent raters screened 196 abstracts, resulting in nine articles that met selection criteria. Data were then independently extracted by the raters. Four of the nine studies used a control condition in their research design (two randomised controlled trials, one controlled but non-randomised study, and one single-case experiment using a changing criterion design). Two of the studies conducted between-group analyses with significant treatment effects for mood and quality of life using active leisure programmes (Tai Chi Qigong and a combined programme of outdoor adventure experiences and goal setting respectively). Intervention programmes identified in the review were then grouped and described according to the approach or model used, including active leisure programmes, social peer mentoring, individual brokered leisure services and a therapeutic recreation model. Additional intervention models and approaches that did not result directly from the systematic review were also described because they provide information on the current approaches used in practice (Clubhouse model and leisure education programmes in the stroke population).Conclusions: There is some evidence for the effectiveness of community-based interventions for leisure/social activity for people who have had a TBI to improve mood and quality of life. The conclusions of this review are that the interventions for this area need to be planned and specific, structured and goal-driven, intensive and conducted over a period of months.

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