Community Support Service for person with Dementia and Carers

Transcription

1 Health Forum on Alzheimer's disease 腦退化醫療知識講座 Community Support Service for person with Dementia and Carers 認知障礙症 - 社區支援服務 Ms Winnie Lui Service Manager (Kin Chi dementia care service), St. James' Settlement

2 Why it is so important to talk about Carer stress? Carer as a hidden patient Carers, particularly women, find themselves being part of the sandwich generation with multiple caregiving responsibilities 80 % of elders are living in community and taking care of by families

3 Why it is so important to talk about Carer stress? Researches show that family members who provide care to individuals with chronic or disabling conditions are themselves at risk - Mental & Emotional - Physical health Most caregivers are ill-prepared for their role and provide care with little or no support National Alliance for Caregiving & AARP (2004) Alzheimer s Association & National Alliance for Caregiving (2004) Family Caregiver Alliance(2006)

4 Stressors faced by carers: Physically demanding tasks of nursing, involving heavy lifting, household chores, walk away or get lost

5 Stressors faced by carers: Psychological burden : Anticipatory grief for the loss of a family member/intimate partner to share affection, thoughts, and experiences 30 to 40%of dementia caregivers suffer from depression and emotional stress Covinsky,K.E.,Newcomer,R.,Dane,C.K.,Sands,L.P.,Yuffe,K. (2003) Complicated feelings- guilt, frustration, anger, drained, guilty or helpless as a result of providing care Pinquart,M. & Sorensen, S.(2003)

6 Indicators for overload or burnout Giving up favorite pastimes? Feeling persistently blue, irritable, helpless/hopeless? Significant changes in appetite/weight, sleep patterns? Feeling exhausted all the time? Can t take anymore? Getting sick more often or develop chronic health problems (headaches, pain, diarrhea, constipation, heart palpitations etc)

7 Regarding the helps the respondents need, all of them looked for more resources to help them release the burden ( Case Study on the Burden Impacted on the Carers Caring of Persons with Dementia 2007 ) Knowledge of medication, diagnosis Economic support More day care centre specific for taking of the persons with dementia is needed Day care centre increases day/ extended time of taking care of the persons with dementia In- home support services available More educational talks/ training course workshop/ resources 24 hours hot line services

8 Identified Needs of the carers Knowledge on dementia (different stage) Handling of behavioral problems Emotional Distress over the caregiving role Feeling of uncertainty toward the prognosis

9 Identified Needs of clients Depression symptoms common in the MCI and early stage of dementia Feeling of uncertainty toward the prognosis Deterioration of self care abilities Long term care plan ( case management model and counseling needs)

10 Disease Progression in Stage MCI- Pre- Dementia Stage Mild / Early Stage Moderate / Middle Stage Severe / Late Stage Terminal Stage

11 Community Resource 現有社區資源 評估 確診及藥物治療 Assessment & Diagnosis, Pharmacological intervention 政府普通科 / 私家醫生門診 GP 記憶診所 memory clinic 專門提供認知障礙症照顧的中心 - 非藥物治療 Specialized Dementia Training centre non pharmacological intervention

12 Service Requirement in the Continuum of care for person with dementia ( HKCSS- dementia task group 策略行動方案 ) Public & Community Organizations Medical Sector - GP - HA SOPC - HA GOPC - HA CGAT - HA PGT - DH Social Service Sector ( NGO) - RCHE (COC/ NH) - Day Care - IHCST ( Ordinary) - IHCST ( Frail/ EHCCS) - DECC/NEC/SE Mild Cognitive impairment ( MCI) Early stage of Cognitive impairment Moderate stage of Cognitive impairment Moderate stage of Cognitive impairment w/ BPSD Late stage of Cognitive Impairment

13 Issues in dementia service in HK Long waiting time for memory clinic Some major hospital appointment >1 year Average time of onset to see memory clinic doctor 2 to 3 yrs Results Delay diagnosis, treatment of reversible causes Delay treatment for dementia Delay organization of multidisciplinary services Increased risk for hospitalization due to risky behavior or BPSD Early and appropriate support to access services is essential to enable people with dementia and their carers to sustain a good quality of life ( Brodaty et al 2005; Bruce & Paterson 2000; Woods et al 2003)

14 Service Requirement in the Continuum of care for person with dementia ( HKCSS dementia task group) Disease progress Mild Cognitive impairment ( MCI) Early stage of Cognitive impairment Moderate stage of Cognitive impairment Moderate stage of Cognitive impairment w/ BPSD Late stage of Cognitive Impairment Service Objectives : Holistic Care to maximize, enhance and maintain functioning levels and to encourage independence as far as possible - Public education & awareness - General health maintenance - Center services for socialization & elder learning programs - Center cognitive training programs - Counselling, legal advice, - Basic home based personal care service - Carer support service - Cognitive assessment for early identification & diagnosis - Day center for socialization and learning - Cognitive training programs - Counselling, legal advise - Carer support and counselling - LTC assessment - Home based personal care and support services - Specialist consultation - Cognitive assessment & training - Orientation training - Non pharmacological intervention - Center services - LTC assessment & referral - Day care & home care training - Informal carer training & support - Counselling & legal protection - Home modification - Specialist treatment for BPSD management - Pharmacologic al & non pharmacologic al intervention - LTC - Day Care & Home Care - Residential care services - Carer support and training - Counselling & legal protection - Home modification - Specialist treatment and monitoring - LTC assessment & referral - Residential care - Care support - Counselling & legal protection - Palliative Care

15 Social services for the elderly Community Support Service: - District Elderly Community Service Center - Neighborhood Elderly center - Social Center for the elderly Long Term Care Service : - Day Care center for the elderly - Respite services - EHCSS - IHCST - Residential care services : C & A Home, Nursing Home Carer allowances / Elderly voucher

16 Kin Chi Dementia Care Support Service Centre (Wan Chai)

17 Background of Kin Chi Our MISSION: Enhance the quality life of the person with dementia and their carers. Arouse public awareness of dementia.

18 Service Objectives By adopting Case management model, we aim to provide a variety services to: reduce the caregiving burden of the family caregivers maintain the social interaction of the clients with outside world design appropriate training programs for individual with identified need or problem

19 專門的社區支援服務 Community Support Service for Cognitive Impairment 服務內容包括 : 1. 及早的專業介入 Early Professional Intervention/ Assessment service 2. 家庭及個別輔導 Family and Individual Counselling 3. 鼓勵參與社交活動 Social Participation 4. 法律意見及申請監護令 Legal advice on guardianship 5. 個案管理 Case Management 6. 認知訓練 Cognitive Training 7. 日間暫託服務 Day Respite 8. 照顧者支援服務 Carer Support Service, 包括 : 工作坊, 支持小組 9. Long Term Care Planning

20 Comprehensive Care Services Day Care Service Home Care Service Carer Support Tailored Made Training Daily Activity Programs Home Training Carer Training Programs Home Assessment Regular Outing Individual Training Programs Behavioral Manageme nt Enhance Daily Living Skill Family Caregiver s Intervention Counseling Service Camp with Intensive Workshops Carer Support group/mont hly Meeting Professional Advices e.g. OT, PT,Psychiatr ist, speech therapist Regular Workshops

21 Place Located in Wan Chai, easy to access Home-like environment

22 日間照顧中心訓練服務 Day Training Services 綜合藝術感觀治療 Multi sensory stimulation, Arts and crafts, music, 記憶訓練 memory training 香薰治療 Aromatherapy 音樂治療小組 Music therapy

23 照顧者訓練課程 Care- giver Support and training 照顧者是我們重要的夥伴, 定期舉辦工作坊協助照顧者掌握認知障礙症的知識及照顧技巧, 課程以互動及協助照顧者提供解決方法和處理 舒緩壓力等技巧 社區教育活動 Community Education and Public awareness 義工訓練及服務 社區講座及展覽 專業同工培訓及講座

24 賽馬會高錕腦伴同行流動車服務服務提供 Brain Health Services ( ) 提供全港 18 區早期檢測 Early Identification in 18 Districts 社區教育 / 早期檢測 / 講座個人及小組訓練 / 家訪 / 專介 服務現況查詢 : / 已完成, 包括深水埗 南區 元朗 觀塘區 中西及離島區 網址 : 黃大仙及北區 葵青區 由 2014 年 10 月 12 月於屯門區服務

25 全港提供認知障礙症服務 的專業機構

26 機構名稱地址電話網址服務 聖雅各福群會灣仔健智支援服務中心 灣仔堅尼地道 100 號賽馬會社會服務大樓 2 樓 kin_chi@sjs.org.hk ( 電郵 ) 日間照顧及訓練 家屬支援 個別輔導 全面評估服務 專業支援及資源中心 聖雅各福群會西環健智支援服務中心 香港西環德輔道西 466 號 3 樓 js.org.hk 日間照顧服務 護老者支援服務及專業支援服務 東華三院渣打銀行 150 週年慈善基金長者智晴坊 香港北角道 16 號蘇浙大廈地下 wahcsd.org 日間中心訓練服務 家居訓練服務 家屬支援服務 專業診斷及跟進服務 黃竹坑醫院 香港黃竹坑黃竹坑徑 2 號 g.hk 專業健康評估 個案分析 訂立醫療及復康計劃 東華三院 智圓全 腦退化症患者社區支援計劃 九龍何文田常盛街 18 號何文田邨景文樓地下 C 翼 wahcsd.org/tc/o urservices/elderlyservices/specializ edservices/coc/intr oduction 認知測試及社區記憶診所服務及日間訓練中心等

27 機構名稱地址電話網址服務 基督教聯合那打素護康院 九龍觀塘協和街 130 號基督教聯合醫院 J 座陳國本大樓 ersole-ssucnh.org.hk 個人衛生照顧 膳食服務 導向訓練等 基督教家庭服務中心智存記憶及認知訓練中心 九龍灣彩霞邨彩星樓地下 4 號 org.hk 免費簡單認知測試 中心認知訓練 到戶認知訓練 聖公會基愛長者鄰舍中心長者益智發展中心 深水埗大埔道 70 號太子中心 2 樓 A 室 wc.org.hk/site/po rtal/site.aspx?id= A8-802 早期患者課程 護老熱線 訓練教材借用 資源閣等 香港認知障礙症協會智康中心 ( 總部 ) 九龍黃大仙橫頭磡邨宏業樓地下 a.org.hk 早期檢測 日間中心 到戶訓練 六藝健腦班 記憶訓練班 資源中心 ( 中心分佈於中環 灣仔 將軍澳 荃灣, 請致電查詢 ) 仁愛堂歐雪明腦伴同行中心 九龍順安道 9 號順天邨天瑤樓平台 201 號舖 ldergarten 為腦退化症患者提供適切及多元化之日間訓練及照顧

28 機構名稱地址電話網址服務 香港耆康老人福利會 陳登滙駿天地 九龍油麻地東莞街 16 號駿發花園第二期地下 I 舖 免費地區檢測 腦健康俱樂部 護老者互助小組等 基督教靈實協會靈實翠林日間老人中心 九龍將軍澳翠林邨康林樓二樓 室 s.org.hk/hohcw_ eng/elder_com2. php 提供治療性的活動 基本護理 個人照顧 膳食 專車接送及暫託服務 賽馬會耆智園 新界沙田亞公角街 27 號 a.org.hk 記憶診所及評估服務 日間護理服務 住宿服務 家屬及照顧者支援 家居訓練服務 賽馬會流金匯腦退化日間護理中心 新界大埔富善邨善鄰樓地下 A 翼及 B 翼 org.hk 物理治療及專業康復訓練 認知小組訓練 社交興趣小組 照顧者支援服務 現實導向訓練小組 日常生活技能訓練 香港聖公會福利協會香港聖公會麥理浩夫人中心社區健康綜合服務 新界葵涌和宜合道 22 號 5 樓 身體檢查服務 心理精神健康評估及支援服務 物理治療服務及中西醫療基層健康服務等

29 機構名稱地址電話網址服務 仁濟醫院嚴徐玉珊卓智中心 新界荃灣福來邨永康樓地下 1-3 號 s.org.hk 日間訓練及照顧服務 患者家居訓練 檢測評估 家屬支援 義工培訓 記憶力訓練課程 復康用品專櫃 仁愛堂記憶診所新界屯門啟民徑 18 號仁愛堂賽馬會社區及體育中心 org.hk 提供診斷 治療及轉介服務 博愛醫院長者日間活動中心 新界元朗坳頭博愛醫院賽馬會護理安老院大樓五樓 k 為患有認知障礙症患者提供非藥物治療方法

30 諮詢熱線 機構名稱電話網址 社會福利署熱線 衛生署 erly 香港房屋協會房協長者安居資源中心 m/erc