The ROSA Team worked with the Quebec Ministry of Health to develop Interdisciplinary Clinical Process in Primary Care for dementia.
This tool for Family Medicine Groups is instrumental for the implementation of the Alzheimer Plan in Quebec. We have now translated it in English and we are delighted to share this work.
The objectives of these Interdisciplinary Clinical Process are to:
- Facilitate the identification, diagnosis and follow-up of individuals who may have Alzheimer's disease, mild neurocognitive disorders (mNCD) or major neurocognitive disorders (MNCD) through a simple clinical process that relies on inter-professional collaboration;
- Promote referrals to main partners in the service proposal;
- Improve the support offered to family caregivers.
This work will useful for other provinces when developing Alzheimer Plans, as well as the Canadian Dementia Strategy.
To view the Clinical Process in Primary Care, please visit the following links.
Interdisciplinary Clinical Process - Diagnosis Component
Interdisciplinary Clinical Process - Follow-up Component
Processus clinique interdisciplinaire - volet diagnostic
Processus clinique interdisciplinaire - volet suivi
ROSA and Partners Receive CIHR Grant for New COVID-19 Project
There is an urgent need to effectively mitigate the rapid spread of COVID-19 and minimize its direct and indirect consequences on persons living with dementia (PLWD) and their caregivers in Canada. There are more than 564,000 Canadians living with dementia. PLWD are particularly vulnerable to the effect of the pandemic.
First, PLWD have a higher risk of infection and of developing severe COVID-19 disease since they may not be able to recall public health recommendations and have a high number of comorbidities which are themselves risk factors for severe COVID-19. Almost 80% of all deaths in the country are now connected to long-term care and seniors’ homes, of which 70% of residents have dementia.
Second, PLWD may also be greatly impacted by the public health strategies such population-level containment strategies and disruptions to access to healthcare. These strategies may also contribute to mental health problems which, in turn, may lead to increased risk of antipsychotic and benzodiazepine use, two medications associated with potentially severe adverse events. Caregivers may also be experiencing burden as formal care services are disrupted for their loved one and for themselves. Additionally, PLWD may not seek necessary care because of fear of infection, which may result in acute or chronic conditions being suboptimally managed leading to increased need for health care services and increased risk of all-cause mortality.
Considering these daunting challenges, members of Team 19 and others put together a proposal for a project titled “Improving the care of older adults living with dementia across Canada during the COVID pandemic: a mixed methods study to inform policy and practice”. The project has received funding from the Canadian Institutes for Health Research for 1 year.
Various stakeholders, representing decision-makers, managers, PLWD, caregivers and clinicians, including the Alzheimer Society of Canada (ASC), provincial Alzheimer societies, the Public Health Agency of Canada (PHAC), the Canadian Foundation for Healthcare Improvement (CHFI), the College of Family Physicians of Canada (CFPC), the Canadian Geriatrics Society (CGS), Dementia Advocacy Canada have combined their efforts with researchers to minimize the effects of the current wave of this pandemic and prepare for subsequent waves of COVID-19.
Our objectives are:
1. To measure the impact of the pandemic on health and social services use, infection rate and mortality of PLWD both in the community and in long-term care facilities.
2. To understand PLWDs’ and caregivers’ perceived needs, behaviors and experiences of health and social services.
3. To generate and disseminate evidence-based and actionable recommendations on effective strategies to tackle the current wave of the pandemic and prepare for future waves.
We propose a mixed-methods design where qualitative and quantitative studies will cross-fertilize each other to examine different aspects of the consequences of the pandemic on PLWD and their caregivers in Canada.
In a first phase, a quantitative study using administrative databases (Objective 1), and a qualitative case study using questionnaire and interviews (Objective 2) will be conducted in parallel in four provinces (QC, ON, AB, SK) and will be replicated in France.
In a second phase, we will integrate the quantitative and qualitative studies in order to identify factors which we can act upon in order to improve PLWD and caregiver outcomes. Finally, we will conduct a deliberative dialogue workshop with key stakeholders (PLWD, caregivers, decision-makers, managers, and clinicians) to generate and disseminate evidence-based and actionable policy and practice recommendations to mitigate negative consequences of the pandemic in a timely fashion (Objective 3). We will leverage our infrastructure, networks and partner’s existing communication platforms (CCNA website, Twitter accounts, Alzheimer Society Canada newsletter, and CFPC listservs) to continuously disseminate practical tools and education material as soon as they become available.
Overall, this research will produce evidence to current gaps on the impact of COVID-19 and facilitate improvement in the design of timely, effective and efficient care systems, service delivery mechanisms and public health policies to better support PLWD and their caregivers.
PROVINCIAL COUNCIL STAKEHOLDER MEETING – 06/07/2019
CCNA PHASE TWO FUNDING – 03/22/2019
Today, the Government of Canada announced the next phase of funding for the Canadian Consortium on Neurodegeneration in Aging (CCNA). From 2019 to 2024, CCNA will receive $46 million from the Canadian Institutes of Health Research (CIHR) and 11 other partner organizations, including the Alzheimer Society of Canada (ASC), and the Fonds de recherche du Québec – Santé (FRQS). Our research team ROSA (Research on Organization of Healthcare Services for Alzheimers) led Drs. Howard Bergman and Isabelle Vedel co-lead the team to continue investigating how to provide innovative care for persons living with dementia. Stay tuned as we unveil the new set of research objectives and methods in the coming months.
CAHS REPORT – 01/17/2019
Recognizing the importance of developing and implementing an effective strategy to address this challenge, the Minister of Health of Canada, through the Public Health Agency of Canada, asked the Canadian Academy of Health Sciences (CAHS) to provide an evidence-informed and authoritative assessment on the state of knowledge to help advance federal priorities under the National Strategy for Alzheimer’s Disease and Other Dementias Act.
To address the charge, the CAHS assembled a multidisciplinary, multi-sectoral panel of six experts with a range of expertise, experience, and demonstrated leadership in this domain, including several members of the ROSA team. See more here
Watch Radio Canada’s mini-series on Alzheimer Disease, with Dr. Isabelle Vedel as a collaborator.
Read a short opinion piece published by our team in The Gazette La Presse on the need for multidisciplinary teams in treating AD.
See short videos of Claire Godard-Sebillotte’s (PhD candidate) research featured by CMAJ at NAPCRG and CCNA at their annual meeting.
Read a featured post on Nadia Sourial’s (PhD candidate) research
Second Provincial Stakeholder Meeting
Stakeholders from Quebec, Ontario, New Brunswick and Alberta, including decision-makers, managers, researchers, and patient and caregiver representatives, were invited to a meeting in Montreal, Canada on June 7th 2019. This full day meeting featured updates on the current state of the ROSA research program in Ontario, Quebec and New Brunswick, as well as on federal initiatives (Canadian Academy of Health Sciences report and Public Health Agency of Canada progress report on the Federal Dementia Strategy). Discussion centered around the use of interdisciplinary primary care teams, the integration of AD evaluation results into policy, and the use and accessibility of community services and resources. View a summary of the day’s discussions here in discussion_summary.pdfand fr_discussion_summary_2017_09.pdf
Quebec, Ontario and New Brunswick Stakeholder Meeting
Stakeholders from Quebec, Ontario and New Brunswick, including decision-makers, managers, researchers, and patient and caregiver representatives, were invited to a meeting in Montreal, Canada on June 16th 2017. The focus of this meeting was on the initial and ongoing results from the evaluation of the implementation of the first phase of the Quebec Alzheimer Plan. Future stakeholder meetings, with the next planned for Fall 2018, will include results from the studied initiatives in Ontario and New Brunswick.
Three major themes led the discussion:
View a summary of the day’s discussions. For a short opinion piece published on the outcomes of this meeting, see our ‘Media’ section.
ROSA International Council Roundtable
During the 21st IAGG World Congress in San Francisco, the ROSA team organized a meeting with our research colleagues from around the world working in evaluation and implementation research of Alzheimer’s plans and initiatives. We were able to catch up on the state of similar research programs internationally, and discuss common barriers and further questions for study that face the field. This international council will continue to exchange information and discuss on these topics, and will aim to culminate in a large international workshop in Canada in 2019.
Are you interested in becoming a part of the International Council?
The council meets annually, often at international conferences, to disseminate and share the latest results and personal experiences working in this field of evaluation and implementation research.
For more about our knowledge translation (KT) events, please contact our KT director: Rachel Simmons (rachel.simmons [at] mcgill.ca)