Dementia: New Model of Home Care Proves Effective in Practice

For many people with dementia, remaining at home for as long as possible is a major wish. However, care can be complex: medication is not always taken as prescribed, outpatient care services go unused, or there is insufficient support with household tasks and transportation to medical appointments. This is where the “Dementia Care Management” program developed by the German Center for Neurodegenerative Diseases (DZNE) comes in. Specially trained nursing staff support those affected and their relatives with organization and care and, for the first time, are also permitted to take on medical tasks that would otherwise be reserved for physicians. The Innovation Committee of the Joint Federal Committee (G-BA) recommends integrating Dementia Care Management into routine care.

The benefits of Dementia Care Management (DCM) have been demonstrated by the InDePendent study, which involved more than 400 participants from Mecklenburg–Western Pomerania, Brandenburg, and Hesse.

• DCM significantly reduces unmet care needs—by around 75 percent after six months compared with standard routine care.
• Quality of life improves measurably, particularly for people with dementia who live alone.
• The burden on family caregivers and general practitioners is reduced.
• The concept is cost-effective: treatment costs that would otherwise be incurred in the long term are avoided.

“The positive vote coming from the G-BA now gives this approach further momentum. We are very committed to implementing dementia care management in practice,” said Prof. Wolfgang Hoffmann, a health services researcher at the DZNE site in Rostock/Greifswald.

In the study, the researchers examined for the first time what it means when dementia care managers, after passing a state examination, are granted medical responsibilities that are otherwise reserved exclusively for physicians. These include, for example, administering injections, prescribing care aids, and treating complex wounds. The dementia care managers carried out these tasks in close consultation with the treating family doctors. “At the same time, the involved family doctors were effectively relieved of part of their workload, as they usually have very limited capacity for home visits,” explains Dr. Anika Rädke, researcher at the DZNE and first author of the scientific publication on the current study.

From the perspective of health insurance companies, Dementia Care Management initially incurs higher costs than standard care—but evaluations show that the concept is cost-effective overall. “You have to consider the savings. Dementia Care Management helps to avoid costs,” says Wolfgang Hoffmann. “If care managers perform medical tasks instead of physicians, it is more economical. In addition, better nursing care contributes to overall health, preventing treatment costs that would otherwise be expected in the long term. Our current findings, together with long-term data from previous projects, show that Dementia Care Management is cost-effective overall.”

Long-term data from previous projects also show that Dementia Care Management helps delay the move to a nursing home—aligning with the wishes of many individuals who want to live independently at home for as long as possible.

The benefits have therefore been scientifically proven, and its integration into standard care is explicitly recommended. The researchers responsible for the Greifswald study now hope that this successful care concept will become a reimbursable service covered by health insurance companies in the future, thereby benefiting many people with dementia in the long term.

Source: DZNE