Annual Report 2015 - Summarized version

The mission of the National Norwegian Advisory Unit for Ageing and Health (Ageing and Health) is to build-up and disseminate competencies within the disciplines of dementia, old age psychiatry, ageing and physical disability, and ageing and intellectual disability. Our target groups are both primary and specialist health services, health personnel, patients and their family members. We conduct extensive research, development and educational activities to increase knowledge within our field.

(Photo: Martin Lundsvoll)

 

Research

Not much research has been conducted within the discipline of ageing and health. In addition, research conducted within the discipline has received relatively little attention. This is due to change, especially within the field of dementia. This development is to a greater degree a result of research conducted by the National Advisory Unit for Ageing and Health, in addition to several years of effort to build a research network across relevant health sectors.

There is a short path from research results to implementation in clinical practice at all levels. This comes as a direct result of our comprehensive teaching activities, publishing unit and periodical. Within our area of expertise, the specialist health services have a particular responsibility to provide quality services for the elderly in the municipalities. This is also reflected by our research activities. We contribute comprehensively to the compilation of the national guidelines and counselling guide in the area of dementia and old age psychiatry. We contribute to such work through the results and experiences from our research.

Ageing and Health has a representative at the board of the network for old age psychiatry research, which covers the areas of Telemark and Vestfold, and wishes to initiate and operate a nationwide research network within old age psychiatry. Ageing and Health is part of the working group that is examining the possibility of including a specific mapping of health among the elderly in HUNT-4, which begins in 2017. There have been efforts to establish several research projects, to include participants from the Northern Regional Health Authority. The result is that two departments from the Northern Regional Health Authority has been included in the Norwegian dementia registry, while two departments from same health authority wish to be included in the quality registry for old age psychiatry as soon as the change in concession is approved by the Norwegian Data Protection Authority (Datatilsynet). This will create a better platform for the establishment of research projects that would include the Northern Regional Health Authority. They are already partners in 6 ongoing research projects at Ageing and Health.

Ageing and Health is engaged in a series of international collaborative networks within research and professional development.

In collaboration with the Directorate of Health, Ageing and Health participates in a Nordic dementia network adopted by the Nordic council of ministers, which is administered by the Nordic Welfare Center. The constituent’s initial meeting was held in Island by May 2015. Norway had the chairperson’s position last year. A principal coordinating work-group was established together with sub-networks for the subject areas of migration and dementia,

intellectual disability and dementia, and welfare technology and dementia. The mandate for the sub-networks was adopted in a meeting hosted by Denmark in the fall of 2015.

The Ministry of Health and Care Services appointed the Directorate of Health and Ageing and Health as participants in the EU commission’s joint action on dementia. Ageing and Health participates in two out of four of the work packages defined. These include timely diagnosis and follow-ups after diagnosis, and 24 hours of care. Ageing and Health is responsible for the leadership of the 24 hours of care work-package through the service of Prof. Øyvind Kirkevold. The year 2015 was used to further develop the project proposal and budget. We have had one meeting in Luxembourg. The commission approved the application for joint action on dementia in December 2015. The project kicks off in March 2016.

Ageing and Health is also involved in the joint action on frailty, were we have a more passive role as participants in the work-package.

The Ministry of Health and Care Services appointed the Directorate of Health and Ageing and Health as the Norwegian representatives for the EU Governmental Experts on Dementia. We had two meetings in Luxembourg with the group in 2015.

Teaching

In 2015, we emphasized on a national day-based course and conferences for larger cities. In the districts, Ageing and Health arranged other course-projects, ABC model (see heading under) and professional seminars. In 2015, we also had a teaching agreement with Diakonhjemmet University College. The collaboration included an agreement that part of our courses on dementia be upgraded and included as a topical course (Elderly and Dementia), carrying a 10 study credits points in the master’s degree program.

We were technically responsible for the sixth (6th) Norwegian geriatric congress and assisted the program group with the completion of the arrangement. In addition, we also participated in the work of the organizing committee for the planning and conducting of the European Union of Geriatric Medicine Society (EUGMS), held in Oslo on 16th – 18th September 2015. In collaboration with the Danish Dementia Research Center and the Swedish Dementia Centre, we organized the third (3rd) leadership conference for leaders in dementia care. The conference will be held in Oslo October 2016.

The National Advisory Unit on Ageing and Health, the Norwegian Association for Ageing related Research, the Norwegian Geriatric Association, NOVA and the Public Health Institute make up the organizing committee for the 24th Nordic congress on gerontology to be hosted in Oslo by 2018.

The ABC-model

Ageing and Health was responsible for the development and implementation of the Dementia Care ABC and the Elderly Care ABC project, which were a segment of the dementia plan of 2015. There is an extensive study material for intern-personnel working in the Health and Care Services sector. The offered trainings are composed of interdisciplinary reflective groups in each municipality, in addition to biannual regional professional training days. As much as 410 municipalities had participated in the trainings by the end of 2015. About 21 849 participants had registered by the end of the year. The work of writing and editing of several supplementary booklets for the Elderly Care ABC project was completed in 2015. These include ABC of psychological conditions in old age, Geriatrics and Physical disabilities, and Intellectual disability and ageing, which are all extensional or supplementary study materials within the discipline of Ageing and Care.

The compilation of the study booklets – Dementia and welfare technology is completed and incorporated with the edited edition of the Dementia care ABC second handout.

We further completed the study materials and organized the implementation of Mitt Livs ABC, prepared for health personnel working with patients with intellectual disabilities, as part of the mandate from the Directorate of Health. An electronic registering system that would facilitate easier registration, reporting and statistics is under development. The digitalizing of the study materials and other additional resource materials are also in progress. In collaboration with the National Competency Center for Culture, Health and Care, we are developing an ABC music-based activity therapy in elderly and dementia care.

As part of the competency elevational plan of 2015, we developed and are already operating a study program for the unskilled where the goal is to obtain a trade certificate as licensed practical nurse. At the end of the year, we had recorded 495 participants registered in the training program, 204 participants had passed the interdisciplinary examination Vg3 in the auxiliary nursing discipline, and 103 of these had passed the final examination. They are currently licensed practical nurses.

Dementia plan for 2015

The Norwegian National Advisory Unit for Ageing and Health, during the last part of the dementia plan period, held courses and gave counselling on the diagnosing of dementia in primary health care services, and on the establishment and running of dementia teams. We organized an annual dementia team conference and completed a quality check of the diagnostic tool and a handbook for diagnosis in the primary health care services. We have completed courses and counselling in establishing and operating of day care activity services and held an experience sharing Conference. Together with the Church City Mission in Norway (Kirkens Bymisjon), we published ‘En dag og en reise’ and booklets titled Fysisk aktivitet og Ernæringsarbeid i dagaktivitetstilbudene in 2015. Discussion groups (samtalegrupper) and/or courses for next-of-kin (pårørendeskole) were organized in 289 municipalities, for persons with dementia and their family members. In collaboration with the National Association for Public Health, we arranged weekend-gatherings for youths (Tid til å være ung) and for younger persons with dementia and their partners (Møteplass for mestring). We also created an animated film aimed at children who are dependents of a parent with dementia. The first national conference for family members of persons with dementia was also organized.

Dementia plan for 2020

The dementia plan for 2020, was launched by the Minister of Health and Care Services Bent Høie during our dementia day event. We participated in the work of the project group together with the Health and Care Service Department, the Directorate of Health and the National Association for Public Health (the user’s organization) for the development of the plan.

Vocational school

The National Advisory Unit for Ageing and Health has its national vocational school that offers studies in Dementia Care and Old Age Psychiatry (DA) as well as Intellectual Disability and Ageing (UA). The school started with the DA emphasis in the year 2008 and the UA emphasis in the year 2013. Both disciplines are recognized by the Norwegian Agency for Quality Assurance in Education (NOKUT), and each considered a one-year unit course that is spread over a two years period. In 2015, the first set of students graduated, with 14 candidates in the UA emphasis and 20 candidates in the DA emphasis. The percentage of completion was around 85%. The candidates receive the qualification known as Vocational Diploma and get 60 vocational school credit points.

Counselling, advisory and sharing of information

We offer comprehensive counselling and advisory within all areas of our expertise. Our services are available for the specialist health service, primary health service, health service planners, volunteers and users (patients and their family members). We spread new knowledge through our website, Facebook and Twitter accounts. Our staff also receives inquiries and attends to them by telephone and email. They travel nationwide to provide advice and counselling to municipalities and other relevant stakeholders, for example in connection with the introduction of new services for patients within our area of expertise. They also participate in local meetings and arrangements on county and municipality levels.

Researchers, students and professionals from across the country, frequently use the library and literature services operated by Ageing and Health. In 2015 for example, the library received around 350 information inquiries, loaned out about 1100 materials, and obtained orders for about 800 articles. The library made about 800 literature searches for staff and external users. Ageing and Health’s publishing unit had total of 12 publications, educational materials, specialty books and reports. We also gave out 2 new lecture films. In all, the publishing unit disseminated 24615 publications. Of these were 6017 study booklets for the ABC-series. We also sold 2070 lecture films and audiobooks.

Four editions of the period A&D was published in 2015. About 2100 printed copies and 1400 subscribers at the end of the year. In the year 2015, the periodical published its first scientific article, which is an important step towards it’s recognition as a level-1 periodical.

Ageing and Health’s websites had 580 885 page views in 2015. There were 106 969 unique users who visited the websites. Our Facebook-page got 1962 likes at the end of 2015.

The staff at Ageing and Health organized 47 (6 scientific and 41 professional) oral presentations and presented 14 posters at national and international conference and congresses.

Quality assurance tools

  • Quality register in old age psychiatry, 2011 – a register with national coverage
  • Biobank linked to the National quality register on dementia, located at Oslo University Hospital, Ullevål, 2009, Biobank
  • National quality register for dementia, 2013 – under the National medical quality register

Ageing and Health is responsible for the National register for dementia. A total of 25 outpatient clinics from all Regional Health Authorities across the country, that provide dementia diagnostic services, contribute to data collection. The register’s main objectives are for quality assurance and to further develop a diagnostic tool to be used in dementia diagnosis; create new knowledge on diagnostics; progression and treatment of dementia, as well as identifying risk factors for dementia, the different types of dementia and the neuropsychiatric symptoms associated with dementia.

So far, data from about 4600 patients have been collected. The objective of the national quality register for dementia is not to evaluate results of treatments, but to evaluate the quality of dementia diagnostic processes.

Ageing and Health has taken over the responsibility for the quality register on old age psychiatry. A research network at Oslo University Hospital, Diakonhjemmet Hospital,

Akershus University Hospital, Vestre Viken HF, and NKS Grefsenlia established the register. The objective of this register is to consolidate the quality of services towards old age psychiatric patients and ensure good and harmonious procedures for diagnosis and treatment. A formal request has been made for a transfer of the concession from Diakonhjemmet Hospital to Ageing and Health’s branch at Oslo University Hospital.

National guidelines/instructional guides

Ageing and Health collaborate with the Directorate of Health on the creation of a national guideline for dementia. We have professional advisers for both groups. The project is divided into ‘diagnosis and medical treatment’ and ‘follow-up’. Many of our staff are involved in the central workgroup and participate in other ways as well.

Task and results

Monitoring and communicating of treatment results

In addition to managing two quality register and a biobank (described under quality assurance tools), we also completed a National mapping of services offered to persons with dementia in all of the country’s municipalities. This was based on a mandate from the Directorate of Health and was published in August 2015.

Participation in research and establishment of research networks

In the year 2015, there were 25 research projects in progress. Sixteen participants of them were within the Regional Health Authorities or with contractual international partners in Nordic countries. Members of our staff have been either main authors or coauthors for 46 scientific articles. We have 11 PhD fellows, 4 post doctorate fellows and 4 professors.

Equitable access to the National Advisory Unit’s services

We work systematically to provide an equitable access to our services. We have created an extensive network both in the specialist health and care services and in the primary health and care services. Senior county officials are partners in the dissemination of information on the mandated projects from the Directorate of Health. Our partners in the specialist health and care services contribute by making us known in the municipalities. Our services are also made known to students and college employees through our collaborations with Universities and University Colleges. Information about courses and conferences are sent to municipalities nationwide by electronic means and through our paper form course catalogues. Many get to know about our services through our periodical Demens & Alderspsykiatri (Dementia and Old age Psychiatry). Our information is also available on the internet. Measures are also been put in place for the upgrading of our website. The project on digitalization of our services is still on course. The aim is to be able to provide easy access through digital media and create access for various target groups. In 2015, we started using social media in a new and systematic manner, which has spread knowledge about our expertise and lead to more visits to our websites.

Contribution to the implementation of national guidelines and Knowledge based practices

With the Directorate of Health, Ageing and Health is planning the implementation of a national guideline on dementia and a national instructional guide for old age psychiatry. Through a mandate from the Directorate of Health and the Health and Care Service Department, Ageing and Health contributes with its own research and through the evaluation of existing research findings, to build the fundamentals for national policies and plans within its organizational disciplines. Ageing and Health also disseminates this fundamental knowledge through its competency elevational measures.

Establishment of a professional reference group

The professional reference group for Ageing and Health has been expanded. Jorunn Helbostad replaces Olav Sletvold from Central Norwegian Regional Health Authority. She has also been chosen as the leader of the reference group. Astrid A. Daniloff is named via the regional Users’ committee, as Users’ representative. Ingrid Haug-Olsen from Trondheim municipality represents the municipality health and care services. The reference group was previously lead by Wenche Frogn Sellæg (representative for the National Association for Public Health), who voluntarily served as the spokesperson in the organization. Others were Bernhard Lorentzen from the Southern and Eastern Regional Health Authority, Cathrine Arntzen from the Northern Regional Health Authority and Marianne Nielsen from the Western Regional Health Authority.

Building-up and dissemination of competences

We have compiled a competency dissemination plan which is available on our website. The competency dissemination plan highlights details of how the competency dissemination’s work, measure and method are organized across the various target groups.

Contribution to relevant teaching

In 2015, the center arranged 33 courses/conferences, amounting to 401 teaching hours and 2964 participants. The courses covered the spectrum of our organizational disciplines and were arranged in all parts of the country.