Project Details

Background

Newer housing models, such as assisted living flatshares, are becoming increasingly popular. Studies indicate that outpatient assisted flat-sharing communities for the target group of people with dementia (PWD) account for around 4/5 of the estimated number of outpatient assisted flat-sharing communities nationwide. The clientele in outpatient assisted shared flats is mostly very old and female, and the risk of hospitalisation can be classified as high for residents of outpatient assisted shared flats. In general, it can be said that hospital patients in Germany are getting older and older. In 2005, 48% of patients in hospitals were aged 60 or older; by 2030, the proportion will be over 55%. However, it should also be noted that the data situation regarding the number of PWD treated in German hospitals is not reliable. One reason for the higher hospitalisation rate of PWD is the presence of complex medical comorbidities. The study situation indicates that hospitalisation can have negative effects for the PWD, but also for their family and for the healthcare system.

Objectives

The primary aim of the project is to reduce the number of hospital admissions for people with disabilities from assisted living communities and the associated follow-up costs.

In addition, insights are to be gained into the frequency of and reasons for hospital admissions of PWD in the setting of outpatient assisted shared accommodation. Secondary project objectives are to improve the quality of life, reduce challenging behaviour, reduce the risk of falls and stabilise the cognitive abilities of PWD. To this end, a complex intervention will be implemented in the planned "DemWG" project, with

(A) a training programme for the people actively working in the WG in recognising the risks of hospitalisation,

(B) promoting the involvement of the responsible doctors in the event of health problems and

(C) a training programme based on the MK-WG therapy concept (training to improve motor and cognitive skills). For this purpose, the already scientifically tested MAKS concept for stabilising the independence and cognition of PWD in care homes is being further developed and newly manualised for the "dementia flat share" setting (MK-WG).

Research question

The study addresses the following questions:

What are the effects of the complex intervention (components A, B and C) on the incidence of hospital admissions and their cost consequences?

How do the measures of the complex intervention (components A, B and C) affect the quality of life, challenging behaviours, falls and cognitive abilities of people with dementia in outpatient assisted living communities?

Methods

A mixed-methods study is planned, which is multicentre, cluster-randomised, prospective (standardised assessments, qualitative expert interviews, focus groups, SHI routine data analysis) and includes a waiting group design - taking into account the phase model of the development and evaluation of complex interventions.

Project address: DemWGuni-bremen.de

Weblink: www.demwg.de

Consortium partners: Centre for Medical Care Research at the Psychiatric University Hospital Erlangen, Prof. Dr Elmar Gräßel, AOK Bremen/Bremerhaven

Partners involved: Competence Centre for Clinical Studies Bremen (KKSB), University of Bremen, Prof. Dr Werner Brannath, SOCIUM Research Centre on Inequality and Social Policy, University of Bremen, Prof. Dr Heinz Rothgang

Cooperation partners: AOK Bayern, AOK Hamburg/Rheinland, Kassenärztliche Vereinigung Bayern; Deutsche Alzheimer Gesellschaft e.V. Bayrisches Landesamt für Gesundheit und Lebensmittelsicherheit; the Bavarian State Ministry of Health and Care - Minister of State Melanie Huml MDL; the Senator for Science, Health and Consumer Protection Bremen - Prof. Dr Heinz Rothgang; the Senator for Science, Health and Consumer Protection Bremen - Prof. Dr Werner Nath, SOCIUM Research Centre for Inequality and Social Policy, University of Bremen; Prof. Dr Werner Nath, SOCIUM Research Centre for Inequality and Social Policy, University of Bremen Quante-Brant; The Senator for Health, Care and Equality Berlin - Ms Dilek Kolat; Provider Association of Quality-Oriented Healthcare Facilities e.V.; the outpatient PFLEGE Bremer Heim-Stiftung; Evangelischer Verband für Altenarbeit und pflegerische Dienste; Coordination Centre for Outpatient Assisted Living Communities in Bavaria; Hamburg Coordination Centre for Residential Care Communities STATTBAU