Hospital-Community Collaboration Cognitive Training Program(HCCCTP) – A Multi-settings One Stop Cognitive Rehab Service for Patients with Mild Cognitive Impairment(MCI) and Dementia

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Authors (including presenting author) :
Leung SN(1), Ng YC(1), Lee WS(1), Kan SY(1)
Affiliation :
(1)Occupational Therapy Department(OTD), Pamela Youde Nethersole Eastern Hospital(PYNEH)
Introduction :
In the ageing population of HK, the prevalence of dementia(>60 years old) is growing sharply with total number increase from 0.11 million in 2010 to 0.28 million in 2036. The resources and manpower required would be enormous. There is a lack of one-stop service in triaging patient’s cognitive function and needs with different rehab resources in HKEC. OTD in PYNEH received over 700 referrals from medical Special Out Patient Department and General Out Patient Department each year. HCCCTP is a one-stop cognitive rehab service developed since Jan 2016.
Objectives :
To reduce the waiting time, increase the intervention quota and new patient head count number for cognitive rehab in PYNEH OTD. To triage patients according to their needs, rehab potential and cognitive impairment level to appropriate services. To enhance the support of patients with cognitive impairment in community by Non-Government Organizations (NGOs).
Methodology :
Patients diagnosed dementia and referred to PYNEH OTD for cognitive assessment or intervention were triaged according to their Montreal Cognitive Assessment Hong Kong Version (HK-MoCA) score, activities of daily living(ADL) level, motivation and carer support. Patients with HK-MoCA score above 16th percentile(Mild neurocognitive disorder – DSM IV) or severe cognitive and ADL function impairment, poor rehab potential would be arranged an OTD session for introducing and referring to the appropriate HKEC NGOs cognitive training services(12 settings) through the HKEC Elderly Platform and HKEC Dementia Network. Patients with HK-MoCA score below 7th percentile(Peterson’s MCI) with high cognitive rehab need and good motivation and compliance would be arranged the OTD intensive out-patient cognitive rehab program(once per week for 24 weeks: total 24 sessions) and refer to HKEC NGOs cognitive training services upon discharge.
Result & Outcome :
From Jan 2016(the launching of the HCCCTP program) till now, the PYNEH OTD out-patient cognitive rehab waiting time was significantly reduced from 24 weeks to 2 weeks. The number of new cases recruited for OTD intensive out-patient cognitive rehab program was 120(average 80 per year). The intervention new case head count for cognitive rehab has been increased double from 48 to 96 yearly. The total patient triaged and referred to HKEC NGO cognitive training services were 75 per year. CONCLUSION An one-stop hospital-community collaboration cognitive training program can provide seamless service for patients with dementia to ensure the continuity and comprehensiveness of patient care. Close partnership with community organization provided outlet for the growing demands of cognitive rehabilitation in dementia population.

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