The United States and China - Sharing Research and Care Approaches for Those with Alzheimer's and Dementia

June 2, 2015 - Mara Botonis
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Mara Botonis is the author of our upcoming Clinical Trials Diary blog series. - Trish 

At the end of a long tree-lined cobblestone road past a fruit and vegetable stand, and next to the remnants of a near century old abode, in the hallways of a hospital built in the 1950's, Dr. Zhang Shouzi rounds on his dementia patients in a 60-bed dementia care wing at Beijing Geriatric Hospital (BGH).

The BGH is located northwest of the Summer Palace in the Haidian District of Beijing and is the only hospital in a city with an estimated 21-22 million people that includes wards specifically for senior dementia patients. The BGH is very well regarded not because it's one of a kind, but because of the staff's commitment to supporting the best possible quality of life for persons with dementia. At this hospital, dementia care includes cognitive, art, music, gardening and even pet therapy. It offers a range of activities you would expect to find in a long-term care setting more than in an acute care environment. BGH blends both Traditional Chinese Medicine (TCM) and Western Alzheimer's approaches.

However, the quality of its programs and rare offerings are struggling to keep up with the demand for them from Chinese families. China has the world's largest population of persons with Alzheimer's, currently estimated at 9.2 million. According the World Health Organization (WHO), one out of every ten people with Alzheimer's worldwide will be a Chinese national living in China.

For decades, China’s family planning laws have permitted only one child per couple in many parts of the country. That policy has brought about a shortage of adult children caregivers.  Additionally, the number of aging parents in China is growing at a record breaking rate.  Currently an estimated 177 million people aged 65 and older live in China, which is home to the largest number of seniors in this age bracket in the world.   By 2050, the Chinese proportion of elderly will reach 30.4%, including 100 million elderly people over 80 years old. This is why China is considered the epicenter of the worldwide Alzheimer's epidemic.

More and more elderly patients with dementia are being put on waitlists for programs such as Zhang's for a variety of reasons. In China, "publicly funded centers for the aged don’t take in patients with dementia diagnosis because it is hard for them to hire staff to take care of them," according to an article in the China Daily by Wang Qingyun.  At Beijing Geriatric Hospital, Dr. Zhang Shouzi and his colleagues are looking to gain and share as much knowledge as they can about improving quality of life for persons with dementia, eradicating the disease and reducing the stigma around these illnesses. 

In China, because public funding is available for hospital care and not for community- based Alzheimer's care, once admitted to BGH it is often difficult to discharge even medically stable persons with dementia. The barriers to community-based assisted living or skilled nursing-type Alzheimer's care in China can often come down to finding affordable non-acute care options. Community-based organization with properly trained staff and a willingness to admit patients with dementia, who can sometimes become violent, assume greater risks and costs for the organizations. 

“None of the other hospitals are willing to take these patients as their wards are full of patients with acute diseases,” says Dr. Shang Lan, Director of BGH's Geriatrics Department.  Without a formal discharge planning process in place, or oversight from a third party payers (such as our US-based Medicare, Medicaid Programs and Managed Health Insurance Providers) that seeks to encourage patient care that is safely managed at the lowest (and least costly) level of care, some of the patients in the BGH have been there for years. "We ask their family members to take them back when their symptoms are stable, but they are reluctant to do so,” states Lan. 

While some work toward finding a cure, there's a simultaneous and urgent need for quality dementia care providers in China.

Enter an incredible relationship between Meridian Senior Living http://www.meridiansenior.com/ a US company known for their highly praised and very person-centered Moments in Time® Memory Care program and Senior Living L'amore (http://www.chunxuanmao.com ), a China-based Assisted Living company crossing the cultural divide to collaborate in creating some of the first examples of affordable person-centered dementia care for the aging in Asia.  The Meridian Senior Living has been spending a lot of time and resources to bring dementia specific training and care programs to the Beijing area.

The relationship between the two senior living companies is built upon connecting Chinese dementia care providers with US Alzheimer's experts; authors, healthcare consultants and teams of operational support personnel to model and train the latest person-centered memory care techniques in a shared effort to improve quality of life for Asian-based elders living with Alzheimer's/dementia. 

Meridian and Senior Living L'amour aren’t the only US-Chinese Alzheimer's advocates working together and it's not just happening on Chinese soil.  

Back here in the US, a non-descript white tour bus comes to a slow stop in front of the University of Southern Florida's Byrd Alzheimer's Institute in Tampa, FL as just under 20 members of a Shanghai, China-based study group of Alzheimer's Care providers and advocates steps out into the bright Florida sunshine with their translators and guides to learn from some of the leading researchers at USF fighting to prevent and eradicate Alzheimer's altogether.

The study group was part of a Care Expo China program overseen by Bromme Hampton Cole, Chairman of the Chinese Geriatric Institute and President of Hampton Hoerter Healthcare a global, diversified health care services company headquartered in Shanghai with offices in New York and Hong Kong. Among other healthcare development services, Hampton Hoerter oversees Care Expo China, the largest, longest lived aged-care multinational conference/expo in China. This year's event will take place in Shanghai in November 17-18th and feature Marc Wortman, the Executive Director of Alzheimer's Disease International as the keynote speaker.

Dr. Zhang, his colleagues in Beijing, the Chinese Alzheimer's Advocates visiting the Byrd Alzheimer's Institute in Tampa and the US-based scientists working there were all invited to collaborate with an innovative American organization seeking to further these types of idea exchanges.  

The invitation came from USAgainstAlzheimer’s, an organization pressing for greater urgency from government, industry and the scientific community in the quest for an Alzheimer's cure. "We accomplish this through effective leadership, collaborative advocacy and strategic investments," per their website.

A network of USAgainstAlzheimer’s is specifically designed to promote and further the science aimed at fighting for a cure - the ResearchersAgainstAlzheimer's Network. "We have heard some say that Alzheimer’s disease is an inevitable part of aging. Others have claimed that it simply cannot be prevented or effectively treated anytime soon. Still others believe that we simply cannot afford to do what it would take to stop the disease. They are all wrong. As men and women of science, we are united by a simple but bold belief: It is possible to prevent and effectively treat Alzheimer’s disease within our lifetimes."

The scientific community of ResearchersAgainstAlzheimer's has "set an aggressive goal of stopping Alzheimer’s disease by 2025, because it will focus the energies of the research community; Invest significant resources in Alzheimer’s disease research and innovation, because our commitment to cures must match the scale of the challenge; Institute reforms to accelerate the drug pipeline and deliver therapies to patients faster, because the ultimate goal of research is to bring help to those afflicted, and to prevent the disease from afflicting future generations."

A noble organization on an important mission to stop a global health crisis already threatening to outpace existing resources both at home and abroad. A fight that can't be more important to the US and Chinese organizations that know all too well the importance of curing or preventing Alzheimer's as soon as possible.

To get involved or learn more, please visit: USAgainstAlzheimer’s.

About the Author

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Mara Botonis

UsAgainstAlzheimer's is a 501(c)(3) organization connecting networks of organizations and individuals to take action to end Alzheimer’s by 2020, while providing the general public, policy leaders and the media with vital information about Alzheimer’s disease.