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Dementia care services in England and France

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Running Head: DEMENTIA CARE SERVICES IN ENGLAND AND FRANCE Dementia care services in England and France [Name of the writer] [Name of the institution] Dementia care services in England and France Intr?ducti?n Pr?f???i?n?l? inv?lv?d in pl?nning ?nd pr?viding h??lth ?nd ??ci?l ??rvic?? n??d ? cr?dibl? m?th?d?l?gy ?upp?rt?d by ?ppr?pri?t? d?t?. ? m?d?lling ?ppr??ch u??? ?ppr?pri?t?ly c?ll?ct?d d?t? t? d?v?l?p ? m?th?m?tic?l m?d?l which ?n?bl?? u? t? und?r?t?nd th? ?y?t?m, pr?dict it? futur? b?h?vi?r, ?nd inv??tig?t? p???ibl? ?c?n?ri?? (McCl??n, 1994). In th? Divi?i?n ?f G?ri?tric M?dicin? ?t ?t. G??rg?'? H??pit?l in L?nd?n w? h?v? b??n d?v?l?ping ?nd t??ting ?uch ? m?th?d?l?gy in ????ci?ti?n with c?mput?r ?ci?nti?t? ?nd m?th?m?tici?n? in ?th?r univ?r?iti??. P?rt ?f th? w?rk pr???nt?d in thi? p?p?r w?? und?rt?k?n by M?y Ling Ch?ng ?? p?rt ?f h?r M?c in D?ci?i?n ?ci?nc?? ?t th? Univ?r?ity ?f W??tmin?t?r, ?up?rvi??d by Dr. T. Ch?u???l?t. In 1995 th? Briti?h G?ri?tric? ??ci?ty u??d ? ?pr??d?h??t m?d?l c?nc?rning th? int?r?cti?n ?f ??????m?nt ?nd r?h?bilit?ti?n pri?r t? l?ng ?t?y c?r? t? und?rpin th?ir ?vid?nc? t? th? IH?u?? ?f C?mm?n? H??lth C?r? C?mmitt??. Th? ?n?ly?i? indic?t?d th?t th? ?ptim?l ?ppr??ch w?? t? intr?duc? ??v?n w??k? pr?-?dmi??i?n ?p?ci?li?t r?h?bilit?ti?n ?? l?ng ?? th? n?w p?licy ?n?bl?d 60 % ?f r?f?rr?d cli?nt?/ p?ti?nt? t? b? m?n?g?d in th?ir ?wn h?m?? (Mill?rd ?nd McCl??n, 1996). D?m?nti? ?nd It? C?r? In ?ngl?nd Th? P?pul?ti?n ?t Ri?k Figur? 1 giv?? th? pr?v?l?nc? r?ti?? ?nd ?xp?ct?d numb?r ?f d?m?nti? ?uff?r?r? in ?ngl?nd in 1991 by ?g? gr?up (65-69, 70-74. 75-79, 85+) ?nd typ? (mild ?r ?dv?nc?d) ?f d?m?nti? (H?fm?n ?t ?l., 1991; ?chn?id?r ?t ?l., 1993). F?r?c??t Incr????? 1991-2031 Figur? 2 ?h?w? th? incr???? p?r ?g? gr?up ?xp?ct?d in th? numb?r ?f c???? ?f clinic?l d?m?nti? b?tw??n 1991 ?nd 2031. Curr?nt C??t ?f C?r? T?bl? I giv?? th? curr?nt ??tim?t?d w??kly c??t ?f c?r? f?r ?ix f?rm? ?f c?r? ?? w?ll ?? th?ir ?v?r?g? c??t? f?r b?th mild ?nd ?dv?nc?d d?m?nti?. ...read more.


?f ?ld?r p??pl?. D?m?nti? ?nd It? C?r? in Fr?nc? In Fr?nc?, th? m?n?g?m?nt ?f ?lzh?im?r'? di????? (?D) ?nd r?l?t?d di??rd?r? h?? b?c?m? ?n imp?rt?nt public h??lth i??u?. Thi? i? n?t ?nly ?xpl?in?d by th? high numb?r ?f p??pl? with d?m?nti? (850,000 c????) ?nd th? numb?r ?f f?mili?? t?uch?d by th? di????? (it i? ??tim?t?d th?t 3,000,000 p??pl? h?v? ? cl??? r?l?tiv? with ?D) (?ffic? P?rl?m?nt?ir? d'?v?lu?ti?n d?? P?litiqu?? d? ??nt�, 2005), but ?l?? by th? n?g?tiv? imp?ct ?f th? di????? ?n f?mily c?r?giv?r?. ?lth?ugh th?r? ?r? ? v?ri?ty ?f c?mmunity ??rvic?? th?t f?cu? ?n m?dic?l, in?trum?nt?l ?nd t?chnic?l ??p?ct? ?f c?r?, int?rv?nti?n? t?rg?ting ?m?ti?n?l ?upp?rt r?m?in r?r?. Thi? ?itu?ti?n i? n?t c?nfin?d t? ?D but f?r di??bility ?nd chr?nic illn??? in g?n?r?l, irr??p?ctiv? ?f th? initi?l pr???nting c?nditi?n. In Fr?nc?, ?? in m?ny ?ur?p??n c?untri??, th? m?n?g?m?nt ?f ?D i? inc?rp?r?t?d within g?n?r?l p?lici?? f?r di??bility, ?nd c?mmunity r???urc?? ?r? divid?d int? h??lth c?r? ?nd ??ci?l ??rvic??, with f?w m?ch?ni?m? in pl?c? f?r ?d?qu?t? c??rdin?ti?n ?cr??? ??rvic??. Th? m??t fr?qu?nt c?mmunity h??lth c?r? ??rvic?? ?dmini?t?r?d t? individu?l? with d?m?nti? ?t h?m? ?r? nur?ing c?r?, phy?i?th?r?py ?nd ?p??ch th?r?py. R?h?bilit?ti?n ?nd c?gnitiv? ?timul?ti?n pr?gr?mm?? ?r? m?inly ?ff?r?d by C?n?ult?ti?n? M�m?ir? d? Pr?ximit� (m?m?ry c?ntr??) ?nd by C?ntr?? M�m?ir?? d? R????urc?? ?t d? R?ch?rch? (CMRR), which ?r? r????rch r???urc? m?m?ry c?ntr?? th?t pl?y ? l??ding r?l? in ??rly di?gn??i? ?nd m?n?g?m?nt ?f d?m?nti?. C?mm?n ?upp?rt ?nd c?r? f?ciliti?? ?ff?r?d by ??ci?l ??rvic?? ?r? h?m? h?lp ?nd g?ri?tric c?r? ???i?t?nc?, which ?r? m?inly d?liv?r?d by ?rg?niz?ti?n? ?uch ?? ????ci?ti?n? ?r c?mp?ni??. Th??? ?r? fin?nc?d ?n ? c?mmun?l ?r ? d?p?rtm?nt?l l?v?l, ?? Fr?nc? i? divid?d int? 'd?p?rtm?nt?' th?t h?v? th? m?in r??p?n?ibility f?r ?dmini?t?ring ?nd fin?ncing ??ci?l ?upp?rt. P?ych???ci?l c?r? h?? ?n ?mbigu?u? ?t?tu?: tr?n?l?t?d int? Fr?nch th? t?rm 'p?ych???ci?l' i? d??crib?d ?? 'm?dic?-??ci?l', r?fl?cting ? p?t?nti?lly m?dic?l f?cu? t? d?m?nti? c?r? ?nd m?n?g?m?nt. It i? m??t fr?qu?ntly ?ff?r?d by h??lth ??rvic?? ...read more.


?r th?r?p?utic ?ng?g?m?nt r?m?in? pr?bl?m?tic. ?t n?ti?n?l l?v?l, curr?nt tr?nd? f?cu? ?n ?upp?rt ?nd r??pit? f?r c?r?giv?r?. H?w?v?r th??? m?y b? diff?r?nt ?t p?rticul?r p?int? in tim? ?nd m?y d?p?nd ?n f?ct?r? r?l?t?d t? f?mily d?m?nd ?nd th? ?t?g? ?f th? di????? pr?c???. Pr?viding v?ri?ty ?f ?upp?rt including r?li?f t? c?r?giv?r? ?t ?ll ?t?g??, r?th?r th?n ?nly during l?t? ?t?g??, ?? i? curr?ntly th? c???, i? imp?rt?nt if c?r?giv?r ?xh?u?ti?n i? t? b? pr?v?nt?d. Th?r?f?r?, int?gr?t?d n??d?l?d c?r? m?n?g?m?nt i? ????nti?l. P?licy b?nchm?rking f?r ?ctiv? c??? m?n?g?m?nt m?y b? n??d?d t? impr?v? c??rdin?ti?n b?tw??n h??lth c?r? ?nd ??ci?l ?upp?rt ??rvic??. R?c?nt inn?v?ti?n? ?uch ?? c?mmunity-b???d multidi?ciplin?ry g?ri?tric t??m? (R�???ux g�r?nt?l?giqu??) ?nd g?ri?tric c?r? ?upp?rt ??rvic?? (CLIC?), pr?vid? ? pr?mi?ing fr?m?w?rk wh?r?by, if d?v?l?p?d n?ti?nwid?, th? ??pir?ti?n? ?f curr?nt p?licy in Fr?nc? m?y b? r??liz?d. H?w?v?r, ?v?lu?ti?n ?f R�???ux g�r?nt?l?giqu?? ?nd CLIC-typ? ??rvic? inn?v?ti?n? will b? n??d?d pri?r t? l?rg?-?c?l? impl?m?nt?ti?n. In c?ntr??t Unit?d Kingd?m p?pul?ti?n i? ?ging ?nd it i? imp?rt?nt t? d?cid? th? ?ppr??ch t? b? t?k?n t? th? m?n?g?m?nt ?f d?m?nti?. U?ing ??tim?t?d c??t? ?f � 150 ? w??k f?r h?m? c?r? ?nd � 350 ? w??k f?r in?tituti?n?l c?r?, ? ?pr??d?h??t m?d?l w?? u??d t? t??t thr?? ?c?n?ri?? f?r ? c?tchm?nt ?r?? with 10.000 ?ld?rly p??pl? with ? pr?v?l?nc? r?ti? ?f 0.054 d?m?nti?, i.?., 540 d?m?nti? ?uff?r?r? with ?n ?v?r?g? dur?ti?n ?f ?urviv?l ?ft?r di?gn??i? ?f thr?? y??r?, i.?., ?n incid?nc? ?f 180 n?w c???? ? y??r. ???uming ? 20 % impr?v?m?nt in th? b?l?nc? ?f h?m? t? in?tituti?n?l c?r? (?ut??t p?r?m?t?r? 40 % h?m? c?r?, 60 % c?mmunity c?r?)n?xt t?rm f?r th? n??d? b???d m?d?l ?nd ? 10 % r?ducti?n in d?m?nd in th? inv??tig?t?ry m?d?l, b?th m?d?l? yi?ld?d ?imil?r ?nnu?l c??t? ?nd ?utp?rf?rm?d th? hi?t?ric ?ppr??ch, yi?lding ??ving? ?n ?n ?nnu?l 7.5 milli?n p?und budg?t ?f � 450.000. ??n?itivity ?n?ly?i? indic?t?d th?t incr????d c??t? ?f inv??tig?ti?n mu?t b? ?utw?igh?d by d?cr????? in th? t?t?l numb?r ?f d?m?nti? ?uff?r?r? ?nd ??tim?t?d th??? d?cr?????. ?lth?ugh pr?bl?m? ?r? inh?r?nt within th? m?d?l, th? r????rch ?h?w? th? p?t?nti?l ?f t?king ? d?ci?i?n ?upp?rt ?ppr??ch t? th? pl?nning ?f d?m?nti? c?r?. ...read more.

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