Implementation of prevention- and patient-centered health care in aging

Dr. Katharina Geschke

Background

Numerous studies have already shown preventive or therapeutic efficacy of several interventions focusing on psychiatric diseases in aging or neuropsychiatric symptoms. However, few strategies are implemented in general health care so far.

Specifically, lifestyle and psychosocial interventions can reduce cognitive decline and timely treatment of depression has impact on the disease course of dementia and on the risk of developing dementia. Psychosocial and psychoeducational interventions, support groups, multicomponent interventions and joint engagements are beneficial for caregivers and for people with dementia. Nonpharmacologic interventions seem to be more efficacious than pharmacologic interventions for reducing for example aggression and agitation in adults with dementia. Nevertheless, in everyday clinical practice these interventions are usually not used. Moreover, not even the regular diagnosis and treatment of psychiatric disorders in aging are in line with the guidelines. Methods to prevent psychiatric disorders in aging as well as good quality care and treatment that meets the often complex needs of this population are required, especially by primary care services.

Research focus

•  Which interventions improve the prevention, the detection or the treatment of psychiatric disorders in aging in line with the guidelines (nonpharmacological, multi-professional, cross-sectoral, in general health care and hospitals, preventing hospital or nursing home admissions)?
• How can these interventions be implemented in regular health care?

Methods

Cross-sectoral clinical studies in ambulatory general health care settings and hospitals

Projects

• DemStepCare: general practitioner-based dementia care with coordinated cooperation and risk-stratified use of specialized nursing staff; Innovationsfonds, 2019-2021.
• Exploratory questionnaire on the situation of caregivers during the corona pandemic and the lockdown
• SET in acute hospital: implementation and evaluation of the Self-Maintenance-Therapy according to Romero in the gerontopsychiatric acute ward
• Unimedicine-wide delirium concept: implementation and evaluation of a delirium concept in the entire University Medical Center of the Johannes Gutenberg University Mainz in cooperation with the board and the service center for patients with cognitive impairments or dementia

Cooperation partners

• Department of Psychiatry and Psychotherapy, University Medical Center Mainz
• Department of Geriatrics, Center for General Medicine and Geriatrics, University Medical Center Mainz
• Pharmacy, University Medical Center Mainz
• Service center for patients with cognitive impairments or dementia, University Medical Center Mainz
• Prof. Dr. Andrea Chmitorz, Fakultät Soziale Arbeit, Gesundheit und Pflege, HS Esslingen
• Dr. Barbara Romero, SET Institut
• Tagesklinik für Psychiatrie und Psychotherapie (TK II), Schwerpunkt dementielle Erkrankungen, gps Mainz
• Landeszentrale für Gesundheitsförderung in Rheinland-Pfalz e.V.