TTSH, polyclinic tie-up sees better care for dementia patients

SINGAPORE — A tie-up between Tan Tock Seng Hospital (TTSH) and Ang Mo Kio (AMK) Polyclinic to care for dementia patients within the community has shown promising results after three years, with patients requiring fewer hospital visits, less stress for caregivers and cost savings to boot.

Since it began in 2012, about 150 patients have been discharged to the AMK Polyclinic’s Dementia Clinic and another 150 have gone to other polyclinics run by the National Healthcare Group. Patients discharged to AMK Polyclinic’s Dementia Clinic saved an average of S$6,700 a year in direct medical costs and indirect social costs, according to interim results of a study by NHG’s research arm, which surveyed 108 patients aged 73 to 76. Money was saved through fewer hospital visits and lower transport costs, for instance.

The partnership has also allowed TTSH to see and diagnose more new patients. TTSH diagnoses up to about 400 cases of dementia a year, and expects to see an increase to 500 to 600 new cases, as well as follow-up cases, said Dr Chong Mei Sian, senior consultant in TTSH’s department of geriatric medicine. Soon, doctors at the AMK Polyclinic’s Dementia Clinic will begin evaluating and diagnosing new cases, allowing more people with dementia to receive medical care more conveniently.

The partnership was the result of doctors, social workers and psychologists from both institutions meeting regularly and sharing experiences to ensure the patients remained well in the community. “The results are very encouraging,” said Dr Chong. While dementia is a progressive disease, appropriate care at various points of patients’ condition will help them to stay healthier, she said.

The partnership will expand into a network called the Geriatric Integrated Network for Dementia, catering to the central region of Singapore. Partners include the Agency for Integrated Care, private general practitioners and the Care for the Elderly Foundation, which runs a programme that provides home-bound patients with advanced dementia more timely access to care. Twelve general practitioners will receive training in dementia care strategies and by November, they will start their practice.

Speaking at a World Alzheimer’s Week event at TTSH today (Sept 22), Ms Denise Phua, Mayor of Central Singapore District, welcomed the provision of more dementia care in the community. She said a home-care programme has eased the stress of caring for her 79-year-old mother, who has severe Alzheimer’s disease, the most common form of dementia. There are now more than 22,000 people here above the age of 65 with dementia, and the number could hit 70,000 in 15 years.

SingHealth, the other polyclinic operator, has a programme with the National Neuroscience Institute at its Geylang and Outram polyclinics for those with dementia. Since its rollout in 2013, the programme has seen more than 450 patients, and 80 per cent of them were referred to the hospitals for early intervention and further specialised assessment. The programme will include dementia education and caregiver training by trained dementia nurses, said Dr Gilbert Tan, SingHealth Polyclinics’ assistant director of clinical services.