Toward the establishment of a community-based integrated care system supporting the lives of elderly patients with dementia

Abstract

After reviewing the direction of the national dementia strategy from the perspective of the establishment of a community-based integrated care system, we present our recent work on strengthening medical services and promoting the early detection and intervention, and the integration of services for elderly patients with dementia. We developed a self-rating scale for assessing the capacity of medical facilities to provide services needed for dementia in terms of 7 latent factors. This scale is expected to be useful for assessing the effectiveness of programs aimed at strengthening medical resources, such as training programs for primary care physicians to increase their capacity to provide general medical services for patients with dementia or public programs for the establishment of a Medical Center for Dementia in each medical service area. We also developed an informant-rating scale for assessing change in behaviors affected by impairment of cognitive function and activities of daily living in patients with dementia, which had adequate reliability and validity as a screening tool for detecting mild dementia. The use of this scale should promote early detection, comprehensive geriatric assessment, access to diagnosis, care planning, and the integration of services for patients with dementia.