Germany’s one-of-a-kind concept aiming to improve the at home medical care for dementia patients delivers first results

Greifswald, April, 16th,2015. Staying at home as long as possible – that’s a wish many dementia patients and their care providing family members hope will come true for them. To make this possible, researchers in Greifswald and Rostock are experimenting with an innovative care concept that is one-of-a-kind in all of Germany and is part of the “DelpHi-MV Study”: Dementia Care Management. The concept assists family practitioners who have their own practices and make house calls by providing them with the support of specifically qualified nursing professions called Dementia Care Managers (DCMs). DCMs visit patients and their family members at home to systematically improve the personal nursing care situation. Yesterday, the participating scientists from the DZNE, the Institute for Community Medicine at the University of Greifswald’s Medical Faculty and family practitioners discussed the status of the study during a symposium held on the occasion of the successfully completed recruitment phase.

Using a computer system that was specifically developed for this purpose, the Dementia Care Managers compile custom tailored treatment and care plans for every patient, which is forwarded to the patient’s family practitioner. The patient’s doctor reviews the proposals and decides which measures will actually be initiated and implemented in cooperation with the Dementia Care Manager. DMCs subsequently visit the patient at home on a regular basis for at least six months. During this time period, the intervention plan is implemented and patient-specific support for the management of the disease is provided. The objective is to ensure care of good and lasting quality. “Our aim is to integrate dementia patients and their families into the regionally available healthcare system as early as possible to improve the patients’ quality of life and to reduce the amount of stress for their families,” comments Hoffmann.

The implementation of the concept has been underway since 2012 as part of the DelpHi-MV Study (acronym for the German title, which translates into “Dementia: Living environment and individual-patient-focused assistance in Mecklenburg-Vorpommern“), which also verifies its effectiveness. The study participant recruitment process has now been concluded. This milestone prompted the researchers involved to invite family doctors to attend this symposium in Greifswald, where the initial internationally published study results were presented and discussed by an enthusiastic panel.

At this time more than 130 family doctors from Mecklenburg-Vorpommern and over 630 patients are participating in the DelpHi-MV Study. The analysis of the data generated already indicates that there is significant need and opportunity for action as far as the early detection of dementia is concerned. The same is true for the provision of needs-adequate treatment and services for the affected patients. The results generated by the study to date have been published in a variety of internationally renowned healthcare magazines. All study participants are interviewed annually to verify the effectiveness of the Dementia Care Management tested in conjunction with the study.

Dementia is a complex disease and does not only affect physical, but also psychological, social and legal aspects. “We need comprehensive care solutions that are tailored specifically to the affected patients and their family members who provide care for them,” observes Professor Wolfgang Hoffmann, speaker for the DZNE site Rostock/Greifswald and managing director of the Institute for Community Medicine. With this goal in mind, Dementia Care Managers keep track records of for instance the health-related complaints of patients, the medication administered and the frequency of doctor’s appointments. Other specifics recorded are the services received from outpatient providers and the stress level of family members. This data makes it possible to determine and address the individual care needed from physicians, through medications and on the psycho-social as well as the social legislation level.

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