The Saskatchewan approach to rural and remote dementia care ANDREW - PowerPoint PPT Presentation

The Saskatchewan approach to rural and remote dementia care ANDREW KIRK MD, FRCPC UNIVERSITY OF SASKATCHEWAN PRESENTER NAME CAHS FORUM ON DEMENTIA SEPTEMBER 17, 2015

Why is there a problem? 1 . Prevalence of dementia increasing. 2. Large rural population (Canada 30%; SK 49%) with access problems. 3. Large older population in SK (14.6%). 4. Seniors more likely to live in rural areas. 5. Large geographic area (1 million people in 652,000 sq. km). PRESENTER NAME CAHS FORUM ON DEMENTIA SEPTEMBER 17, 2015

Saskatchewan is a big place with few people PRESENTER NAME CAHS FORUM ON DEMENTIA SEPTEMBER 17, 2015

Strategy for AD & Related Dementias in SK (2004) “It was like climbing a mountain to get a diagnosis.” - Focus group comment. PRESENTER NAME CAHS FORUM ON DEMENTIA SEPTEMBER 17, 2015

PRESENTER NAME CAHS FORUM ON DEMENTIA SEPTEMBER 17, 2015

THE GOAL To develop and evaluate a streamlined interdisciplinary “one - stop shopping” clinic for patients from rural and remote Saskatchewan for diagnosis and management of dementia and to evaluate telehealth as a means of delivering follow-up care to patients and their families PRESENTER NAME CAHS FORUM ON DEMENTIA SEPTEMBER 17, 2015

INITIAL TELEHEALTH VISIT WITH BLOODWORK PRESENTER NAME CAHS FORUM ON DEMENTIA SEPTEMBER 17, 2015

CLINIC DAY (THEN) PRESENTER NAME CAHS FORUM ON DEMENTIA SEPTEMBER 17, 2015

NOW PRESENTER NAME CAHS FORUM ON DEMENTIA SEPTEMBER 17, 2015

CLINIC DAY PRESENTER NAME CAHS FORUM ON DEMENTIA SEPTEMBER 17, 2015

CLINIC DAY Joint and individual assessments by neurologist, neuropsychologist, physiotherapist, dietitian. Neuro-imaging PRESENTER NAME CAHS FORUM ON DEMENTIA SEPTEMBER 17, 2015

Original Buschke Cued Recall Test PRESENTER NAME CAHS FORUM ON DEMENTIA SEPTEMBER 17, 2015

Pictorial Prairie Buschke PRESENTER NAME CAHS FORUM ON DEMENTIA SEPTEMBER 17, 2015

END OF CLINIC DAY Inter-disciplinary meeting of all professionals involved with family doctor on telephone. Meeting with patient and family to discuss diagnosis, treatment. PRESENTER NAME CAHS FORUM ON DEMENTIA SEPTEMBER 17, 2015

CLINIC DAY 1700: Patient and family head home. PRESENTER NAME CAHS FORUM ON DEMENTIA SEPTEMBER 17, 2015

STEP 4 – FOLLOW-UP 6 Weeks 12 Weeks 6 Months 12 Months OR PRESENTER NAME CAHS FORUM ON DEMENTIA SEPTEMBER 17, 2015

WHO DO WE SEE? Alzheimer’s Disease 194 43.6 Mild Cognitive Impairment 68 15.3 Normal 60 13.5 Frontotemporal Dementia 46 10.3 Lewy Body Dementia 22 4.9 Vascular Dementia 20 4.5 Vascular/Alzheimer’s Dementia 12 2.7 Head Injury 5 1.1 PRESENTER NAME CAHS FORUM ON DEMENTIA SEPTEMBER 17, 2015

Travel saved by Telehealth (km per round trip) (n=363) Mean distance to Telehealth = 71 Mean distance to Saskatoon = 529 Distance saved by Telehealth = 458 PRESENTER NAME CAHS FORUM ON DEMENTIA SEPTEMBER 17, 2015

Family/Patient Satisfaction with Telehealth Would you use Telehealth again? Yes: 100% Would you recommend Telehealth to another person? Yes: 97% PRESENTER NAME CAHS FORUM ON DEMENTIA SEPTEMBER 17, 2015

Satisfaction with Appointments (n = 58) Mean (SEM) Min Max F(1,56) p TH 4.66 (0.11) 1 5 2.05 0.158 IP 4.48 (0.09) 3 5 No difference in satisfaction 1 = very dissatisfied, 5 = very satisfied

Convenience of Appointments (n = 58) Mean (SEM) Min Max F(1,56) p TH 4.78 (0.08) 3 5 37.78 < 0.0001 IP 3.76 (0.15) 2 5 Telehealth significantly more convenient 1 = very inconvenient, 5 = very convenient

Can Cognition be Followed over Telehealth? Mini-mental Status Scores (N = 71) In-person: 22.34 +/- 6.35 Telehealth: 22.70 +/- 6.51 PRESENTER NAME CAHS FORUM ON DEMENTIA SEPTEMBER 17, 2015

FUNDING Then: CIHR-funded research project Now: Funded directly by provincial government PRESENTER NAME CAHS FORUM ON DEMENTIA SEPTEMBER 17, 2015

A GLIMPSE TOWARD THE FUTURE Working with rural and remote health regions to streamline and improve the journey for those with dementia and their families. PRESENTER NAME CAHS FORUM ON DEMENTIA SEPTEMBER 17, 2015

CONCLUSION A multi- disciplinary “one -stop shopping” Rural and Remote Memory Clinic with telehealth follow-up is a convenient, valid, effective, and transferrable way to improve the care of those with dementia and their families. PRESENTER NAME CAHS FORUM ON DEMENTIA SEPTEMBER 17, 2015

The Saskatchewan approach to rural and remote dementia care ANDREW - PowerPoint PPT Presentation

The Saskatchewan approach to rural and remote dementia care ANDREW KIRK MD, FRCPC UNIVERSITY OF SASKATCHEWAN PRESENTER NAME CAHS FORUM ON DEMENTIA SEPTEMBER 17, 2015 Why is there a problem? 1 . Prevalence of dementia increasing. 2. Large

screens support rural dementia families Karina Ross, Social Programme Manager Dementia Friendly

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The Saskatchewan approach to rural and remote dementia care ANDREW - PowerPoint PPT Presentation

The Saskatchewan approach to rural and remote dementia care ANDREW KIRK MD, FRCPC UNIVERSITY OF SASKATCHEWAN PRESENTER NAME CAHS FORUM ON DEMENTIA SEPTEMBER 17, 2015 Why is there a problem? 1 . Prevalence of dementia increasing. 2. Large

screens support rural dementia families Karina Ross, Social Programme Manager Dementia Friendly

Rural and Remote Communities Cathy Zarchynski, RN CNS Substance Use Erin Wiltse, RN - Practice

A Whole Systems Approach to Providing Great Care for People with Advanced Dementia or Frailty

Non-pharmacological Approach to Behaviour that Challenges Jennifer Casson Advanced Dementia

Agriculture in Saskatchewan Value Added Opportunities Presented by the Saskatchewan Ministry of

Using contemporary educational practice to improve rural and remote practitioners responses

People with dementia have rights too Gavin Terry Policy Manager People with dementia have

Is a global rural and remote health research agenda desirable or is context supreme? Jane

Remote Community Care: The Looma Project Indigenous Dementia Services Study Kate Smith and

solution for rural and remote health care Aidan dan Hobbs bbs Business Lead Outreach

DEMENTIA DEMENTIA Dr. Ross Alexander Dunne Consultant Old Age Psychiatrist Dementia Lead,

The Curriculum for All Project SD 74 The Project SD 74 5 rural and remote communities in

PRIORITIES CLOSING THE GAP WITH A FENCE IN THE WAY 2 nd Rural and Remote Health Scientific

emergency departments (EDs)? A before and after study of 26 rural and remote EDs Ling Li Euan

COVID-19 Pathway May 5, 2020 Healthy People, Healthy Saskatchewan The Saskatchewan Health

The Saskatchewan Labour Market The Saskatchewan Labour Market Presentation to: Doug Elliott

Delirium &amp; Dementia Nicholas J. Silvestri, MD Outline Delirium vs. Dementia Neural

Dementia in Australia A lot has happened! 2004 the Dementia Initiative ($320m over 5 years)

Dementia Care Vicki Leah Nurse Consultant Older People Dementia care Dementia and Dignity

Point - of - Care Testing Across Rural and Remote Emergency Departments in Australia: Staff

Using Telecare to enhance childrens outcomes in rural and remote Australia The Royal Far West

Signs of Dementia W hat Everyone Needs to Know Presented by: Gayleen Bradley Certified Dementia

Longitudinal detection of dementia through Introduction Motivation &amp; lexical and syntactic

Dementia and the Memory Service What is it? What do we do about it? Content Dementia

Delirium & Dementia Nicholas J. Silvestri, MD Outline Delirium vs. Dementia Neural

Longitudinal detection of dementia through Introduction Motivation & lexical and syntactic