Health care for people with dementia in 2030 – Results of a multidisciplinary scenario process
Despite extensive research funding in the field of dementia, deficits in the quality of dementia care still exist. In order to project different alternative futures of health care for people with dementia (PwD) in Germany, we have initiated a multidisciplinary scenario process (Sce-Dem). For the scenario process we used a 6-step approach: (1) identification of relevant areas of influences via literature review and internet search, (2) systematic collection of relevant influence factors and their future projections via literature review, brainstorming and consensus workshops, (3) discussion and validation of the identified key factors in a workshop with 52 multidisciplinary, experts, to clarify their characteristics and future projections, (4) combining the relevant key factors with alternative projections in a so-called consistency matrix to estimate the consistency between the selected projections, (5) generating consistent combinations of projections using software, and (6) writing scenario stories and descriptions based on the most consistent and different combinations. As a result of the scenario process, five consistent scenarios were developed. Two of these could be described as dark scenarios with very poor prospects. A third one has been referred to as "well-meant, but badly done". Two scenarios entail mostly positive aspects but one of them has a tendency towards, a "health control" state. The more positive scenarios provide a framework for determining relevant actions in research, society, and politics.
- [Show abstract] [Hide abstract] ABSTRACT: New and innovative concepts of care management have been developed to improve the health of older adults with dementia and depression. This article describes the American aging brain care (ABC) program and the possible transfer to the German healthcare system is discussed. The ABC medical home model in Indianapolis incorporates a specialized geriatric heathcare center which is affiliated to the Eskenazi Hospital as well as a program involving home-based domestic visits by healthcare personnel to affected people. The diagnoses are made in the geriatric center where therapy and treatment are also planned. These stages are carried out in a multiprofessional team, which identifies the individual needs of the patients and relatives and discusses these in family conferences as well as in close consultation with the primary care center of the hospital. The care, diagnosis and therapy are coordinated using a self-developed software for the program and via predetermined pathways and procedural intructions on the approach in the healthcare center and in the domestic visit program. From the perspective of the authors the core elements of the program include not only the use of a home-based care model but also the selection and training of a new type of front-line care provider. Models like the program presented here show great promise for meeting the demands of a rapidly expanding population of vulnerable older adults.0Comments 0Citations
- [Show abstract] [Hide abstract] ABSTRACT: Background: The scenario technique is a method for future research and for strategic planning. Today, it includes both qualitative and quantitative elements. The aims of this scoping review are to give an overview of the application of the scenario method in the fields of health care and to make suggestions for better reporting in future scenario projects. Methods: Between January 2013 and October 2013 we conducted a systematic search in the databases Medline, Embase, PsycInfo, Eric, The Cochrane Library, Scopus, Web of Science, and Cinahl since inception for the term 'scenario(s)' in combination with other terms, e.g. method, model, and technique. Our search was not restricted by date or language. In addition, we screened the reference lists of the included articles. Results: A total of 576 bibliographical records were screened. After removing duplicates and three rounds of screening, 41 articles covering 38 different scenario projects were included for the final analysis. Nine of the included articles addressed disease related issues, led by mental health and dementia (n = 4), and followed by cancer (n = 3). Five scenario projects focused on public health issues at an organizational level and five focused on the labor market for different health care professionals. In addition, four projects dealt with health care 'in general', four with the field of biotechnology and personalized medicine, and additional four with other technology developments. Some of the scenario projects suffered from poor reporting of methodological aspects. Conclusions: Despite its potential, use of the scenario method seems to be published rarely in comparison to other methods such as the Delphi-technique, at least in the field of health care. This might be due to the complexity of the methodological approach. Individual project methods and activities vary widely and are poorly reported. Improved criteria are required for reporting of scenario project methods. With improved standards and greater transparency, the scenario method will be a good tool for scientific health care planning and strategic decision-making in public health.0Comments 0Citations