Through their activities with the Japan Psychiatric Hospitals Association, the author has tackled the dissemination of the regional cooperation pass "orange note," and, through management of the Regional Dementia-related Disease Medical Center, regional cooperation for dementia.
The role of psychiatric hospitals in dementia is often spoken of as being limited to inpatient treatment, however in reality they work not only with the hardware aspects, such as outpatient care, severe dementia day care, and dementia-related disease medical centers (hereinafter abbreviated as "Centers") and the like, but there are many hospitals that also handle care facilities in a psychiatric hospital or home-base related services, making them resources for the region. Meanwhile, on the software side of things, there are human services professionals such as medical and psychiatric welfare workers and social workers including dementia specialists, nurses, pharmacists, clinical psychologists, occupational therapists, physical therapists, etc. with the ability to function cooperatively with interdisciplinary counterparts in each area.
Presently, at the author's hospital, the possibility of effectively utilizing a regional cooperation pass coordinated by the center as a regional cooperation tool is being explored. Additionally, rather than capturing the opposing concepts of community and hospitalization, it is thought that hospitalizing patients within their lives in the community will lead to shortening the length of hospital stays as a result.
Up to this point, regarding regional cooperation, operation with a roundtable way of thinking had been imagined, however unfortunately, it is thought that it has fallen into "meetings with the goal of meeting." It is felt that perhaps a multilayer structure with shades of gray is necessary. A four-layer structure with a "stable condition, does not specifically require cooperation" group, a "requires loose cooperation" group (using a paper-based regional cooperation pass), a "slightly close cooperation, able to intervene when necessary" group (using a regional cooperation pass (ICT)), and a "conduct care conferences dealing with various problems, requires strong information exchange" group has been proposed.
Additionally, at present, there is misperception with the concepts of the dementia model and the Alzheimer's dementia model, they are confused as being the same despite the fact that Alzheimer's dementia is a subcategory of dementia. In particular, I proposed my plan with the thought that it is necessary by this point to organize an alternative, with more rigid BPSD and cognitive symptoms assuming the symptomology of Alzheimer's dementia.
<Author's abstract>
The Role of Psychiatric Hospitals in Community Cure for Dementia Patients
Japan Psychiatric Hospital Association
Ogaki Hospital
Ogaki Hospital
Psychiatria et Neurologia Japonica
118: 849-855, 2016
<Keywords:local community network, clinical pathway, orange note, online network, Regional Dementia-related Disease Medical Center>