Dementia Care in 9 OECD Countries: A Comparative Analysis ...

1 DELSA/ELSA/WD/HEA(2004)4. Dementia Care in 9 OECD countries : A Comparative Analysis Pierre Moise, Michael Schwarzinger, Myung-Yong Um and the Dementia Experts' Group 13. OECD HEALTH WORKING PAPERS. Unclassified DELSA/ELSA/WD/HEA(2004)4. Organisation de Coop ration et de D veloppement Economiques Organisation for Economic Co-operation and Development 28-Jul-2004. _____. _____ English text only DIRECTORATE FOR EMPLOYMENT, LABOUR AND SOCIAL AFFAIRS. EMPLOYMENT, LABOUR AND SOCIAL AFFAIRS COMMITTEE. Unclassified DELSA/ELSA/WD/HEA(2004)4.

2 OECD HEALTH WORKING PAPERS NO. 13. Dementia CARE IN 9 OECD countries : A Comparative Analysis . Pierre Moise, Michael Schwarzinger, Myung-Yong Um and the Dementia Experts' Group JEL Classification: I10, I18, I19. English text only JT00167819. Document complet disponible sur OLIS dans son format d'origine Complete document available on OLIS in its original format DELSA/ELSA/WD/HEA(2004)4. DIRECTORATE FOR EMPLOYMENT, LABOUR AND SOCIAL AFFAIRS. OECD HEALTH WORKING PAPERS. This series is designed to make available to a wider readership health studies prepared for use within the OECD.

3 Authorship is usually collective, but principal writers are named. The papers are generally available only in their original language English or French with a summary in the other. Comment on the series is welcome, and should be sent to the Directorate for Employment, Labour and Social Affairs, 2, rue Andr -Pascal, 75775 PARIS CEDEX 16, France. The opinions expressed and arguments employed here are the responsibility of the author(s) and do not necessarily reflect those of the OECD. Applications for permission to reproduce or translate all or part of this material should be made to: Head of Publications Service OECD.

4 2, rue Andr -Pascal 75775 Paris, CEDEX 16. France Copyright OECD 2004. 2. DELSA/ELSA/WD/HEA(2004)4. ACKNOWLEDGEMENTS. We would like to thank Patrick Hennessy and Peter Scherer for their helpful comments and suggestions on previous versions, Gabrielle Hodgson and Veronique De Fontenay for their valuable assistance with the statistical aspects, Karinne Logez for helping with the translation of French documents and Victoria Braithwaite for helping us with the text and editing. A special thanks to Marianne Scarborough for her tireless efforts in proofreading several versions of this paper.

5 We are indebted to Lynelle Moon, the original study leader, who deserves much of the credit for the study's success. Dr. Richard Suzman of the US National Institute on Aging originally conceived of the idea of an OECD Dementia study. We owe a special debt of gratitude to Dr. Suzman in particular for his intellectual support of the study and to the National Institute on Aging, National Institutes on Health, Department of Health and Human Services, USA* and the Department of Health, Labor and Welfare in Japan in general for their generous financial support.

6 Finally, this paper has benefited from the direction given by the study's expert group, whose names are provided below, and their numerous suggestions for improving the paper's content. *National Institute on Aging Grant No. Y1 AG 9363 05. Experts from Participating countries Australia Australian Institute of Health and Welfare: Anne Jenkins and Diane Gibson; Department of Health and Ageing: Joanne Ramadge, Warwick Bruen, Jacky Fogerty, Bronwen Harvey, David Cullen, Mark Thomann and Virginia Arrowsmith. Canada University of Toronto: Jennifer Tranmer, Ruth Croxford and Peter C.

7 Coyte; Health Canada: Ian Clark. France DREES: Magali Coldefy and Emmanuelle Salines; DHOS: Marie-Fran oise Gu rin;. INSERM: Catherine Helmer; Laboratoire d'Economie et de Gestion des Organisations de Sant . (LEGOS): Marie-Eve Joel and Robert A. Haas; Minist res de la Sant , de la Famille et des Personnes Handicap es: Diane Lequet-Slama. Germany Technische Universit t M nchen: Alexander Kurz, Horst Bickel and Julia Hartmann;. Federal Ministry of Health and Social Security: Gabriele Langerhans. Japan National Institute for Longevity Sciences: Takeshi Tabira, Hiroshi Shimokata and Yumiko Arai; Chubu National Hospital: Hidetoshi Endo; Tokyo Metropolitan Institute on Aging: Akira Honma.

8 Obu Dementia Care and Training Center: Yutaka Mizuno. Spain Hospital Universitari arnau de Vilanova: Jos ngel Monta s; Ministerio de la Sanidad y Consumo: Isabel De La Mata Barranca; Universidad de Zaragoza: Antonio Lobo. Sweden Ministry of Health and Social Affairs: Catharina Morthenson Ekel f; Stockhom Gerentology Research Center: M rten Lagergren and Anders Wimo. United Kingdom University of Cambridge: Julia Zaccai, Carol Brayne, Fiona Matthews and Lu Gao;. University of Newcastle: John Bond; Department of Health: Jane Allberry, Thomas Kutin, Paul Faulkner, Raphael Wittenberg, Allan Cox, Rachel Tully, Margherita D'Cruz and Tom Dening.

9 United States Duke University: Gerda Fillenbaum, Jama L. Purser, Albert Heyman. 3. DELSA/ELSA/WD/HEA(2004)4. SUMMARY. 1. Dementia and its most common manifestation, Alzheimer's disease, is a complex disorder that afflicts primarily the elderly, affecting an estimated 10 million people in OECD member countries . The complexity of the disease makes treating Dementia extremely difficult, involving a wide variety of social and health care interventions. Typically, these two aspects of Dementia care are examined separately. This paper adopts a conceptual model that examines both types of interventions and how they interact along the Dementia care continuum.

10 2. There are no effective health care treatments for stopping Dementia , which is why the social care aspect plays an important role in treating the disease, with family members an integral part of this process. This paper shows that programs designed to help alleviate the burden of family members caring for a relative with Dementia can have positive health benefits to both patient and family. In particular, the use of group-living, where Dementia patients are housed with other patients to provide temporary relief, is shown to be more effective than other forms of respite' care.