Support Web Based Services for People withDementia and Informal Caregivers in Greece

Thursday 14 May/Olympia A/Chair: Eleni Margioti

Recent Developments in ICT sector for People with Dementia andInformal Caregivers in Greece. Margioti E.

Web Services for Greek Informal Carers. Efthymiou A.

An e-learning tool for the paid caregivers in Greece. Vlachogianni A.

9th Panhellenic Conference on Alzheimer’s Disease & 1st Mediterranean onNeurodegenerative Diseases, 14-17 May 2015, Thessaloniki, Greece

Recent Developments in ICT sector for people withDementia and informal caregivers in Greece.

Eleni Margioti, M.Sc.

Clinical Neuropsychologist

Athens Association of Alzheimer’s disease

& Related Disorders

9th Panhellenic Conference on Alzheimer’s Disease & 1st Mediterranean onNeurodegenerative Diseases, 14-17 May 2015, Thessaloniki, Greece

Athens Association of Alzheimer’s Disease& Related Disorders

First some things about us…

www.alzheimerathens.gr

Athens Association of Alzheimer’s Diseaseand Related Disorders

Is a non-profit organization founded in 2002 by patients,carers, doctors and other health professionals

Aims to advocate for people with dementia, inform thepublic, educate and support caregivers and offer a betterquality of life for patients and families

Currently consists of 4.450 members Has a staff of 30 health professionals (Psychiatrist,

Neurologists, Psychologists, Nurses, Social Worker, SpeechTherapist, Art Therapist, Assistants – Administrativepersonnel)

Dementia Day Care Centers in Athens

Currently Athens Association of Alzheimer’s Disease and RelatedDisorders runs 4 Day Care Centers located in different areas inAthens.They are funded by the European Community and the GreekMinistry of Health and Social Solidarity.

500 patients and 200 carers attend these programs!

Athens Association of Alzheimer's Disease & RelatedDisorders

Co-financed by Ministry of Health & E.U.

Day Care Center in Mets

Day Care Center in Panormou

Day Care Center in Maroussi

Home Care Program

Site: www.alzheimerathens.gr

Activities

35.6 million people were estimated to be livingwith dementia in 2010, a figure expected todouble by 2030.

There are 7.7 million new cases of dementiaeach year, implying that there is a new case ofdementia somewhere in the world every fourseconds.

The accelerating rates of dementia arecause for immediate action, especially inLMIC where resources are few.

Increased longevity comes with increasedfunctional and cognitive impairment.

Incidence and prevalence of dementia isrising

“It’s a global epidemic and it is only getting worse,” saidADI’s executive director Marc Wortmann.

Dementia: a global epidemic

People live for many years after the onset ofsymptoms of dementia. With appropriate support,many can and should be enabled to continue andcontribute within society and have a good quality oflife.Models of best practices are needed to ensure thewell-being of older people in the health system(World Health Organization 2001).

Care and services for people withdementia include:- Early diagnosis- Provision of support in the community- Integrated health and social care programs(e.g. Day Care Centers, ICT programs)

- Take into account the needs of specific or minoritypopulations

Health and social systems development

Alzheimer’s disease treatments

Currently there is no cure for Alzheimer’sdisease

Medicines in use only mitigate thesymptoms

It is increasingly recognized that nonpharmacological treatments for dementiashould, in best practice, be pursued early inconjunction with antidementia drugs

Prevention strategies for Alzheimer’s diseaseinclude mental stimulation activities

• Non-pharmacological treatments are important, maximize the positiveoutcome of pharmacotherapy

• No side-effects, easily adjusted to individual and family needs

• Adjustable to the severity and the type of cognitive deficit

• Offered in various formats - individually or in groups, applied eitherseparately or as a part of a wider intervention program

• Usually applied in Dementia Clinics, Day Care Centers

• In Greece, Day Care Centers run under the auspices ofAlzheimer’s organizations

Non pharmacological interventions

Cognitive Training Definitions

Cognitive training: Guided practice on a set of standard tasks designedto reflect particular cognitive functions, such as memory, attention, orproblem-solving (executive function).

Cognitive rehabilitation: More individualized approach to helpingpersons with cognitive impairments with more of an emphasis onimproving everyday functioning.

Clare, et al., 2009

Cognitive training

The experimental program improved generalizedmeasures of memory and attention more than an activecontrol program. Participants who used the brainfitness program performed as well as those 10 yearsyounger on memory and attention tests for whichthey did not train.

Cognitive training: a guide for health careprofessionals. N. Karpathiou et al.Athens Alzheimer’s Association, 2012, UniversityStudio Press

Cognitive training

Dementia policy - the role of Assistive technologyand ICT

The National Dementia Strategy was published in 2009 and makes explicit

reference to the potential benefits of telecare!

Three key steps Ensure better knowledge of dementia and remove the stigma Early diagnosis, support and treatment Develop services to meet changing needs better

The needs of people with dementia and their carers should be included in the development ofhousing options, assistive technology and telecare. As evidence emerges, commissionersshould consider the provision of options to prolong independent living and delay reliance onmore intensive services.

Information and communications technology (ICT)

ICT is an umbrella term that includes any communication device or application,encompassing: radio, television, cellular phones, computer and networkhardware and software, satellite systems e.t.c, as well as various services andapplications associated with them, such as videoconferencing and distancelearning. ICTs are often spoken of in a particular context, such as ICTs ineducation, health care, or libraries.

According to the European Commission, the importance of ICTs lies less in thetechnology itself than in its ability to create greater access to information andcommunication in underserved populations.

ICT for independent living and elderly care at home. Their strategy isfocused on: reducing growth in long-term care needs increasing access to and quality of care services increasing productivity and jobs in the care sector reinforcing the efficiency of long-term care systems

Benefits from ICT programs

Quality of lifebenefit

Enhanced self-careand independence

Fairerdistribution of

resource

General Positive Outcomes of ICT Programs

Improved or sustained cognitive functioning compared to controls

Improved (less) depression

Higher QoL scores

Improved self-esteem compared to controls

Improved physical functioning

Lower stress

Overall improved social functioning

1. Long Lasting Memories (LLM)

Long Lasting Memories (LLM) is an integrated ICT platform whichcombines cognitive exercises with physical activity in theframework of advance technologies.

LLM aims to deliver an effective solution against age-related cognitivedecline, and to allow the recovery of higher cognitive functions in peoplewho show cognitive impairment related to Mild Cognitive Impairmentand Mild Dementia

www.longlastingmemories.eu

LLM Design Idea

Physical training exercises

Results were promising, indicating that healthy elderly and older adultswith mild to moderate impairment could be benefited by LLMcognitive and physical training software.

Effectiveness of the platform in several cognitive functions.Specially memory (recognition, working memory and immediate recall)can be enhanced by cognitive and physical LLM training.

Elderly reacted positively to the use of technology in the treatment.

Conclusions

2. Alzheimer Hellas: computerizedcognitive exercises

Computerized applications for cognitive training andevaluation of cognitive functions:

• Cognitive screening test

• Virtual supermarket

• Virtual garden

• Virtual washing

Internet based support groups for older caregivers have the potential to provide an excellent

way to give and receive social support. Online support groups can help replace the loss of in

person social support that can be experienced with the 24h provision of care.

Family caregivers, largely women, provide the health and social care for dependent family

members who have long-term chronic illnesses.

Intervention programs for family caregivers typically focus on:

support and/or educational groups

individual psychotherapy

interventions focused on the care recipient such as respite care or

combinations of two or more of these approaches.

3. Alzheimer Hellas: Internet-based support groups forcaregivers

Improving carer wellbeing delays nursing homeplacement

Improved caregiver satisfaction with support, response to problem behaviours,reduced depression, improvements in caregiver stress, depressive mood,subjective well-being, and coping ability.

Together accounted for 61.3% of beneficial impact on placement.

Greater access to counselling/support has benefits for patients, caregivers andsociety.

Mittelman et al., 2006

4. SOCIABLE

SOCIABLE is a multinational and multicenter ICT project piloting an approachfor the support of mental activity of the elderly people

The program addresses to cognitively intact elderly, persons with Mild CognitiveImpairment and people with mild AD

The programme includes:

Innovative, easy to use equipment (Microsoft Surface Table or Tablet PCs)

27 computerized games with advanced difficulty especially designed to

exercise memory, attention, executive functions e.t.c.

A computer mediated reminiscence therapy programme: “Book of Life”

24 hourly sessions performed twice weekly individually or in small groups,

under the guidance of a healthcare professional, in Day Care Centers and

Memory Clinics

www.sociable-project.eu

5. SET CARE program

The program is funded by the EuropeanCommission and its implementation inGreece has been approved by StateScholarships Foundation

There is any cost to participate in theprogram

AIM: The development of a new commontraining tool in Greece and Bulgaria in orderto improve the professional skills that paidcarers should have in order to provide theappropriate care to the frail elderly.

6. Innovage program

The aim of the project is to increasethe effectiveness of regionaldevelopment policies in eco-INNovation for smart hOme andindependent liVing solutions forelderly people and to increase thequality of life of Ageing people.

www.innovage-project.eu