Using Living Labs to Explore Needs and Solutions for Older Adults With Dementia: Scoping Review.

BACKGROUND: Numerous living labs have established a new approach for studying the health, independent living, and well-being of older adults with dementia. Living labs interact with a broad set of stakeholders, including students, academic institutions, private companies, health care organizations, and patient representative bodies and even with other living labs. Hence, it is crucial to identify the types of cocreations that should be attempted and how they can be facilitated through living labs. OBJECTIVE: This study aims to scope publications that examine all types of living lab activities, exploring the needs and expectations of older adults with dementia and seeking solutions, whether they live in the community or long-term health care facilities (LTHFs). METHODS: This scoping review was reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) recommendations for the extension of scoping reviews. We searched six bibliographic databases for publications up to March 2020, and a forward-backward citation chasing was performed. Additional searches were conducted using Google Scholar. The quality of the selected papers was assessed. RESULTS: Of the 5609 articles identified, we read 58 (1.03%) articles and retained 12 (0.21%) articles for inclusion and final analysis. All 12 articles presented an innovative product, developed in 4 main living labs, to assist older adults with cognitive disorders or dementia living in the community or LTHFs. The objectives of these studies were to optimize health, quality of life, independent living, home care, and safety of older adults with cognitive disorders or dementia, as well as to support professional and family caregivers or reduce their burdens. The overall methodological quality of the studies ranged from poor to moderate. CONCLUSIONS: This scoping review identified several living labs playing a pivotal role in research aimed at older adults with dementia living in the community or LTHFs. However, it also revealed that living labs should conduct more better-quality interventional research to prove the effectiveness of their technological products or service solutions. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2147/SHTT.S233130.

[Interests and need for strengthening home care in the context of psychological crisis situations - The result of a strong public health policy]. / Intérêts et nécessité du renfort des soins à domicile dans le cadre des situations de crise psychique - Le résultat d'une politique de santé publique forte.

With the constant increase in life expectancy and the development of chronic diseases in the elderly population, the General Direction of Health of the Canton of Vaud has developed a community plan to strengthen the care of residents in psychological crisis. This strong position of Public Health has made it possible to carry out an ambitious project, with a view to « care management ¼ in elderly psychiatry, involving partners from the care network and promoting care at the place of residence of the individual. This project made it possible to develop recommendations for the strengthening of local and outpatient care, in order to reduce the systematic recourse to hospitalization, and the increase in functional dependence of the elderly on leaving the hospital.

Avec l'augmentation constante de l'espérance de vie et le développement des maladies chroniques, la Direction générale de la santé du canton de Vaud a développé un dispositif communautaire de renforcement des soins pour les résidents en situation de crise psychique. Cette prise de position forte a permis la réalisation d'un projet ambitieux, dans une optique de care management en psychiatrie de l'âge avancé, impliquant les partenaires du réseau de soins et favorisant la prise en soins sur le lieu de vie de l'individu. Ce projet a permis d'élaborer des recommandations quant au renforcement des soins communautaires et ambulatoires, afin de lutter contre le recours systématique à l'hospitalisation, et l'augmentation de la dépendance fonctionnelle des âgés au sortir de l'hôpital.

Demographics, Clinical Characteristics, and Therapeutic Approaches among Older Adults Referred to Mobile Psychiatric Crisis Intervention Teams: A Retrospective Study.

BACKGROUND / AIMS: The advent of mobile old age psychiatry intervention teams supports policies maintaining older adults in their habitual living environments, even those who are very old and suffering from acute cognitive and psychiatric impairments. Analyzing sociodemographic data, clinical and health characteristics, reasons for crisis-oriented psychiatric consultations, and other therapeutic suggestions for supporting home- or nursing home-dwelling older adult patients suffering from an onset of a psychiatric crisis. METHODS: Reviews of the medical records and discharge letters of home- or nursing home-dwelling older adults who had undergone a consultation with the Lausanne region's Mobile Old Age Psychiatry Teams (MOAPTs), between May 2016 and December 2017. RESULTS: Of 570 older adult patients referred for consultation with MOAPTs, 333 had medical records and discharge letters eligible for retrospective analysis (59%). The majority of these older adult patients were women aged over 80 years suffering from dementia, mood disorders with and without a risk of suicide, and delirium. Challenging behaviors related to different stages of cognitive impairment were the most important clinical reason for crisis consultations. Nonpharmacological and pharmacological treatments were delivered concurrently in 68% of crisis consultations. CONCLUSION: Appropriate responses by dual nurse-psychiatrist teams using crisis-oriented nonpharmacological and pharmacological interventions decreased hospitalization.