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In this issue

•  What is dementia?
• What’s the difference between Alzheimer’s Disease and Dementia?
• Programs and Initiatives supporting Primary Care Health
• Support Services for Patients and Caregivers
• Upcoming QI Events

What is dementia?
Dementia isn’t a natural part of aging, as it’s an abnormal degeneration of the brain which causes changes in an individual’s ability to think, speak, socialize and participate in daily activities¹. Dementia is a medical term used to describe a set of symptoms affecting brain function that are caused by neurodegenerative and vascular diseases or injuries such as Alzheimer’s disease, vascular dementia, Lewy Body disease, head trauma and more^2,3.

Symptoms of dementia can include^1,2,3:

• Memory loss
• Difficulty with thinking, problem-solving or language
• Awareness of person, place and time can be impacted
• Loss of understanding and judgement
• Changes in how the individual expresses their emotions
• Changes in personality
• Problems coping with day to day activities
• Problems with socializing

419,000 Canadians of the age 65 years and older are living with a diagnosis of dementia of which almost two thirds are women². Within Ontario, 111,000 individuals live with dementia of which many reside in the community with complex care needs; this number has increased by 46% between 2009/10 and 2015/16⁴.

What’s the difference between Alzheimer’s Disease and Dementia?

The material was created by Dr. Sabina Brennan of Trinity College Dublin and Trinity Brain Health with financial support from GENIO. © 2017 Trinity Brain Health. Permission to use this material was granted by Trinity Brain Health (trinitybrainhealth.com) which reserves all rights in the material.

Programs and Initiatives supporting Primary Care Health

2 out of 5 Canadian doctors feel well-prepared to manage community dementia care; however, with the growing number of individuals being diagnosed with dementia it’s crucial to be aware of the supports available⁵.

• A physician, Nurse Practitioner or any IHP can make a referral to First Link, a program designed to help connect individuals newly diagnosed with dementia and their families/caregivers to Alzheimer Society for services and support
• Multispecialty Interprofessional Team (MINT) Memory Clinics offer clinicians training through a standardized nationally accredited training program. There are over 100 MINT Memory Clinics across Ontario – a special congratulations to AFHTO member Centre for Family Medicine FHT’s Dr. Linda Lee who recently received a 2019 Joule Innovation Grant Award that will allow for the MINT clinics to continue to scale up
• The Rural Dementia and Action Research (RaDAR) Team is a research team from three provinces (Saskatchewan, Alberta and Ontario) and the United Kingdom with a goal to improve healthcare delivery to people with people with mild cognitive and dementia and their caregivers in rural and remote communities
• Mount Sinai Hospital has also designed a Dementia Toolkit for Primary Care which includes resources specific to primary care such as assessment and screening tools, medication management, driving safety and much more
• Centre of Effective Practice has created the Use of Antipsychotics in Behavioural and Psychological Symptoms of Dementia (BPSD) Tool
• HQO has previously created Dementia Quality Standard which addresses care for community-dwelling people living with dementia
• A list has been put together by the Alzheimer Society with multiple avenues of professional development in terms of caring for individuals with dementia
• A list of tools to assess pain levels for healthcare professionals have been put together by the Alzheimer society
• eConsult is a secure web-based tool that allows a physician or nurse practitioner timely access to specialist advice, including psychologists, and often eliminates the need for an in-person specialist visit
• SwitchRx is a website that aims to provide healthcare professionals with the most current and useful information to guide their clinical practice when adjusting their patient’s psychotropic treatment regimens
• eHealth centre of excellence community portal always has some tools being released that can be translated into your EMR!

Support Services for Patients and Caregivers

• HQO has developed a Patient Reference Guide with questions patients can ask their caregivers
• Dementia Advocacy and Support Network (DASN) is a worldwide online organization for those diagnosed with dementia working together to improve their quality of life  
• There are support groups for families and friends of individuals diagnosed with dementia offered by the Alzheimer Society  
• Mount Sinai Hospital has put together a list of caregiver support services available within Ontario
• A range of brochures and publications can be found for both patients and caregivers on the Alzheimer Society website

Upcoming QI Events:

• AFHTO 2019 Conference – Sept 19 & 20, 2019
• OntarioMD EMR Every Step Conference – Sept 26, 2019
• Toronto International Conference on Quality in Primary Care – Nov 16, 2019
• Implementation of Advance Care Planning, Goals of Care and Health Care Consent in Ontario Webinar hosted by HQO – Sept 19, 2019 12:00 – 1:00 pm
• Palliative Care Data Measurement Webinar hosted by HQO – Sept 26, 2019 12:00 pm

References:

1. Dementia in Older Adults. https://camh.ca/en/health-info/guides-and-publications/dementia-in-older-adults.
2. “What Is Dementia?” Alzheimer Society of Canada, https://alzheimer.ca/en/Home/About-dementia/What-is-dementia.
3. Let’s make our health system healthier. “Evidence to Improve Care.” Behavioural Symptoms of Dementia – Health Quality Ontario (HQO), https://www.hqontario.ca/Evidence-to-Improve-Care/Quality-Standards/View-all-Quality-Standards/Behavioural-Symptoms-of-Dementia.
4. Spotlight on Dementia Issues | CIHI. https://www.cihi.ca/en/dementia-in-canada/spotlight-on-dementia-issues.

In Case You Missed It: Check out eBulletin #89 or other back issues here!
Questions? Comments? Contact us at improve@afhto.ca.