Integrated dementia care centers in Southern Taiwan: Experiences from Chi Mei Medical Center

Background Taiwan is facing a social crisis of super‐aged society. In response to the increasing burden, Taiwan launched the Dementia Plan and Action Plan 2.0, which is a part of Long‐term Care Service Network in 2018. The integrated Dementia Care Centers (IDCC) and Support Centers for People with Dementia and their Families (SPDF) were funded under this plan. We reported the executive experiences of IDCC and SPDF in our institution. Method We recruited patients with mild to moderate dementia or diagnosed MCI from (1) who received ambulatory care from our hospital and (2) who was referred from neighborhood hospital/clinics. Patients with severe medical comorbidities or disability were excluded. We analyzed those received follow‐up for more than 12 month or died within the period. Age, gender, clinical diagnosis, education, baseline cognitive assessment, dementia severity (CDR), medical treatments, behavior and psychological symptoms(BPSD), long‐term care services usage, 12‐month‐follow‐up cognitive assessment and CDR were analyzed. Result We recruited 453 subjects in the first year. Among the recruited patients, 121 women and 72 men completed 12‐month follow‐up. The average age was79.2 (SD=8.4) in women, and 80.0(+7.5) in men respectively. Moderate or above disease severity was more common among in women. Low educational level was more in women than men (57.9% vs 22.2%). Alzheimer’s disease (AD)was the most common diagnosis. Thirty‐six patients had a least one documented BPSD or took antipsychotic agents during the observation period. Most patients at mild to moderate stages, the primary caregiver were their spouses or offspring. More than a half of severe patients needed to hire a foreign caregiver. Only 25.2% patients requested long‐term care services. The most commonly used service were day‐care facilities. Conclusion Our analysis demonstrated that senility and late diagnosis were still challenging in Taiwan society. The causes of low utilization of long‐term care services were quite diverse and heterogeneous among geographical regions. How to reduce the caregiver burden and improve the efficiency of long‐term care services needs further optimization and communication.