Authors (including presenting author) :
Kwok CY (Presenting Author) (1,2,4), Pun HY (1,2,4), Tang WS (1), Chan CC (3), Tsoh MY (3), Cheung SY (1), Wong SM (3), Sze YM (1), Ngai WC (5), Chan WM (1), Chan SF (1), Cheung CL (1), Ho YS (1), Lam CM (1), Tsang KW (1), Cheng ST (2), Fung WY (2), Wong PS (2), Chui CM (2), Ho KY (2)
Affiliation :
(1) Department of Medicine and Geriatrics, Shatin Hospital, Hong Kong (2) Jockey Club Centre for Positive Ageing, Hong Kong (3) Department of Psychiatry, Shatin Hospital, Hong Kong (4) Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong (5) Department of Psychogeriatric, Shatin Hospital, Hong Kong
Keyword 1: :
Cognitive impairment
Keyword 2: :
Medical-Social Collaboration
Introduction :
Hospitalisation is prevalent among people with cognitive impairment, while it is associated with higher mortality rate, prolonged stay, and physical and cognitive deconditioning. Non-pharmaceutical intervention promoting positive well-being may could be arranged for the well-being of inpatients with cognitive impairment; however, heavy hospital staff workload limits the capacity of intervention delivery.
Objectives :
This programme adopts a medical-social collaboration model in hospital setting to provide meaningful engagement and care with VERA (Validate, Emotion, Reassure, Activity) Model to people with cognitive impairment and their caregivers. By cooperating and manipulating social-sector partnerships, caregivers will be linked to NGO for stress management to relieve the caregiving burden and subsequence dementia support. To assess possible conditions like apathy, delirium or other distressed behaviors, various of preparations and specific recommendation of care from the team are done to preserve the quality of life.
Methodology :
Inpatients with cognitive impairment admitted to Shatin hospital in Hong Kong will be invited and referred by ward managers to participate in this collaboration. Trained activity practitioners with particular dementia care skills from social-sector partnership will visit referred inpatients in a weekly basis, to assess their needs and family concerns, and giving general to specific activities to start the engagement. Non-pharmacological interventions aim at stimulating orientation and reaction. These activities adapted from the Tailored Activity Program for Hospitalised Patients, comprises two 1-hour sessions over two weeks, focusing on positive psychosocial activities such as art therapy, music therapy, and reminiscence. The delivery will be provided by NGO staff to avoid burdening hospital personnel. Care partners receive two sessions of support for post-discharge needs. Responses of inpatient after activities will be shared with care partners by phone calls and online chat to continue successful engagement and caring skills at home.
Result & Outcome :
For referred inpatients with apathy, they felt being cared and their responses increase with positive feedback and appreciation from the families as well as hospital staff. For delirium and agitation, tailored activities based on person-centred care and more engagement time showed cooperative response shared by ward staff in medication administration and meal intake. Through VERA model with personhood care, caregiving learnt to re-connect. Patients with their care partners felt respect and more willing to seek help in the community. In the coming days, it is valuable to explore the feasibility of incorporating this medical-social collaboration model in hospital setting for better synergy between pharmaceutical and non-pharmaceutical interventions by research support. This innovative model leverages NGO expertise for in-hospital therapy, potentially stabilising the condition of inpatients with cognitive impairment, promoting ageing in place.
