Authors' objectives: The assessment questions covered the necessary criteria and parameters for the service offerings: the target clientele or critical masses, the nature and modalities of service delivery, human or professional resources, and the clinical processes for: memory clinics; Alzheimer support centres; BPSD teams. Note that these three specialized services may be part of broader services such as mental health services or geriatric services, but they may also be fully independent structures within these services. These three structures offer services adapted to the evolving needs of people with Alzheimer's disease and of their caregivers and also regularly collaborate with primary care services involved in screening, treatment, psycho-educational interventions, psychotherapy and respite services for these people. Memory clinics diagnose and treat more complex cases; Alzheimer support centres facilitate access to information and local resource; and BPSD teams intervene to assess, diagnose and develop intervention plans when the symptoms are too complex or persistent. It must nevertheless be acknowledged that it is sometimes difficult to distinguish between primary care services and specialized services (e.g., the definitions or functions attributed to these services are not always clearly specified).

Authors' recommendations: An exhaustive, descriptive review of the literature and of government documents revealed that there is little information on the organizational structures of specialized services offered to people with Alzheimer's disease and to their caregivers. Some relevant information is nevertheless available from policy documents and descriptive studies of the health systems in Australia, France, the U.K., and Canada (Ontario and Québec). In this literature, certain aspects meet with consensus and could guide the development of programs for people with Alzheimer's disease in Québec. The U.K. manual of standards and England's audit tool are also documents likely to be useful in organizing memory clinics. Considering the magnitude of Alzheimer's disease and the paucity of the literature on the organizational structures of specialized services for people with this disease and their caregivers, high-quality research on the organization of specialized services is needed in order to develop integrated care models meeting the needs of this clientele. A disease as complex and prevalent as Alzheimer's must be considered a priority in Québec's health system, as it is in other countries such as Australia, France and the U.K., which have implemented public policies on this disease. These policies recognize the importance of funding research, supporting caregivers, developing professional care providers' competencies, and improving the care delivered to affected people, among other issues. In Québec, services are already being offered to these people within existing structures. It would be desirable to maintain and enhance Québec's current resources or to create new ones, according to the different regions' needs, by integrating them into the current health service architecture, while respecting their hierarchy. Specific policies, guides and practice tools, based on the local and international experiences presented in this report, must be developed to ensure that standardized services are delivered in continuity in order to offer the best care to patients and caregivers and to meet the challenge raised by Alzheimer's disease.

Project Status: Completed

Year Published: 2012

URL for published report: http://www.inesss.qc.ca/fileadmin/doc/INESSS/Rapports/OrganisationsSoins/ETMIS2012_Vol8_No16.pdf

URL for additional information: http://www.inesss.qc.ca/fileadmin/doc/INESSS/Rapports/OrganisationsSoins/INESSS_Summary_Alzheimer_EN.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Institut national d'excellence en sante et en services sociaux

Contact Address: L'Institut national d'excellence en sante et en services sociaux (INESSS) , 2021, avenue Union, bureau 10.083, Montreal, Quebec, Canada, H3A 2S9;Tel: 1+514-873-2563, Fax: 1+514-873-1369

Contact Name: demande@inesss.qc.ca

Contact Email: demande@inesss.qc.ca

Copyright: L'Institut national d'excellence en sante et en services sociaux (INESSS)